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ARE STEROID INJECTIONS FOR SIJ ARTHRITIS THE BEST TREATMENT?…

As I have written before I am having big problems with pain in my SIJ due to arthritis with referred pain into my hip causing bursitis.

Last November I had steroid into both hips for the bursitis and a further CT guided steroid injection into my SIJ. I found they both helped with the pain but four months later the pain all started coming back again. My left sacroiliac joint has been terrible for some time now. It wakes me up when I turn over in bed. It’s painful to lie on my side and sit in a certain position and I cannot stand for long in one spot so I was keen to get another injection as soon as possible.

My insurance company had told me last time that they would not cover me for any more injections and with lockdown pain management appointments are a long way off so I decided to go back and pay for one myself. After a quick examination my consultant offered me another steroid injection into my bursa which was again inflamed and offered me another SIJ injection for my sacroiliac joints were causing significant pain when he checked me out.

He said he would arrange for me to have another CT guided steroid injection into my left SIJ but pointed out that it is not something I can keep having done. The two other options he talked about were bilateral sacroiliac joint radiofrequency ablation which I will cover in this post or if this did not work then I could have fusion surgery to my sacroiliac joints, but I have said time and time again that surgery was not something I wanted to go through again.

I looked into the radiofrequency ablation and on an NHS website it explained what this type of treatment is for and what happens during the treatment.

Each of the sacroiliac joints has its own nerve supply, the lateral branch nerve, which normally carries information about the state of the joint to your brain e.g. pain caused by inflammation, joint position etc. These nerves can be numbed / blocked by your doctor using a local anaesthetic to assess if they are transmitting pain signals (Diagnostic). Radiofrequency denervation, which is the burning of these nerves, is then performed at a later stage in order to interrupt the nerve supply and pain messages for a significantly log time. This prevents the passage of pain signals to the rest of the nervous system. The aim of this treatment is to interrupt the nerve supply to the affected sacroiliac joints.

The treatment involves –

  • A small needle is placed in the back of your hand for sedation or emergency drugs.
  • SIJ RFD is performed lying face down.
  • Your back is cleaned. The skin is numbed with some local anaesthetic is injected which stings a little.
  • A special X-ray and a radiofrequency generator machine will be used by the doctor to identify the location of the nerve.
  • Electrical tests will enable the tip of the specially designed needle get close to the nerve. The final electrical test is done to make sure that the needle tip is well away from the main spinal nerve to your leg, thereby improving the safety of the procedure.
  • When the doctor is happy with the needle position, local anaesthetic is injected before a high frequency (radiofrequency) electrical signal is passed down the needle for 90 seconds.
  • You may feel discomfort at this stage.
  • After each lesion, the area is injected with a mixture of local anaesthetic and steroid, to help reduce discomfort afterwards.
  • Depending on the technicality of the procedure and your medical condition, you may be offered a pain killer or sedative as agreed with your doctor.

There are of course a few complications that could arise but that applies to any type of treatment even with the steroid injections.

In an article on the Spine-Health website it says that the success rate has conflicting results. Success usually depends on the accuracy of diagnosis, variations in the anatomy of the nerve, and the type of technique used. Some patients have reported up to 100% reduction in pain from RFA. Research suggests:

  • RFA performed for the facet joint may provide pain relief in 45% to 60% of patients.
  • RFA performed for the sacroiliac joint may provide pain relief in 75% to 86% of patients.

Typically, if effective, RFA may provide pain relief lasting 6 months up to 2 years. However, some studies have shown patients experiencing pain relief up to 3 years. During or after this period of time, however, the nerve usually regenerates, and the pain may or may not return. The pain relief from this treatment is usually more significant when performed on the facet joints as compared to the sacroiliac joints. Some patients may not experience any relief from pain after this procedure.

I have now been passed onto the NHS pain team who have been in touch and need to refer me to a special triage service who will chat with me then refer me onto the appropriate person to chat about whether this is something I should or should not think about having done. In the meantime the steroid in my hip has helped and my SIJ injection is due at the end of the month.

I understand I cannot keep having steroid injections as there is concern and some evidence that frequent shots can cause damage to the tissue and cartilage within the joints. I guess I have to leave it to the experts to advice me.

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TO BETTER DAYS WITH HEALTHIER JOINTS AND MUSCLES…

To Better Days from a clinic in New Zealand. This is the story of where this business began.

Dr John Lyftogt has been treating patients for nerve, joint and muscle ailments for over 30 years. In this time, he noted a lack of development in treatments for long-term sufferers (with the exception of opioids which can create other problems). Frustrated by the indifference shown by modern medicine, John and his physical education specialist wife Maria set out to explore new ways to help those suffering with long-term muscle, joint and nerve pain.

Using his scientific understanding of the body and connecting with medical professionals around the globe who specialize in muscle, nerve and joint pain, John developed a range of radical new treatments.

These have been used at his clinic in Christchurch as well as by a global network of doctors. John and Maria taught, and continue to teach, thousands of doctors around the world to this day.

The next step was to bring this treatment to sufferers outside of the clinic too. The patent for the topical formulation was taken out in 2010. Devastatingly, the development program was delayed not once but twice by earthquakes at its base in Christchurch.

Yet John and Maria were resolute in continuing to help more people around the globe – to show them there is another way and to lead them To Better Days.

Their comprehensive website covers lots of articles on exercise, mental health, nutrition, pain management, science, sleep, wellbeing and some personal stories. You can join there community at To Better Days to share and find tips. You could spend literally hours just reading through it all.

Their active joint patches soothe discomfort and improve the health of joints, nerves and muscles. You simply apply the patch directly where you need it and feel the benefit in as little as 30 minutes, with results that last up to 24 hours. They offer a trial pack which offers a combination of 3 big joint patches and 6 small joint patches. allowing you to trial our product on your back, shoulders, knees, fingers, wrists and ankles, at only £9.59.They kindly sent me this back to give a try.

With chronic pain in a number of areas I had to decide which area I might benefit from the most. I decided to try the largest of the patches on my hip just before I went to bed. The reason I chose to put it on then is because it’s my hip pain that wakes me up every night without fail so anything to give me a full nights sleep would be wonderful.

I was soon asleep as usual but the amazing thing was that the next time I woke up it was my alarm clock ringing out at 7.15am. I had actually slept through the night without waking up in pain. For me to just get one full nights sleep a week is a miracle.

On the instructions it says apply to clean, dry skin and apply directly to the affected area. The activation mark will disappear once the patch starts working. It then says peel off after use and remove any residue with warm soapy water. I shower every morning so I knew the patch would have to come off and I did notice my skin was quite irritated by it. This is not the first time this has happened. I have tried many different patches but always end up with an irritation. Ordinary plasters also cause me the same problem.

I felt pretty gutted after having such a good nights sleep. This will not stop me from using it again but maybe try the smaller patch next time and for the 12 hours instead of 24 so that I can get the benefit of the patch. 72% of customers rate their patches as excellent, with most saying they experienced a reduction in pain.

#backpainblog, #BACKPAINBLOGUK, #covid-19 App, #fibromyalgia, #fibromyallgia symptoms, #health, #hip pain, #lowbackpain, #pain, lower back pain, Migraine, Migraine relief

COVID-19 VACCINES AND MIGRAINES…

Migraine Relief Centre have written this post about Covid-19 and migraines which I thought my readers would find very interesting.

Thanks to hardworking researchers and modern medicine, it seems like there is finally a light at the end of the tunnel of the COVID-19 pandemic. With several vaccines now available, many people are able to protect themselves against infection. However, some may have reservations about the injection. Here are some answers to common questions about vaccinations, specifically for migraine sufferers:

  • Will the vaccine trigger a headache or migraine? In clinical studies, some recipients reported experiencing head pain after vaccination. However, side effects like this are normal, typically mild, and short-lived.
  • Should I skip the second dose if I experienced headaches after the first? Most of the available vaccines require two doses to be fully effective, so do not delay or skip the second dose.
  • Will the vaccine cause persistent migraines? There is no reported evidence that the vaccine causes headaches or migraines. However, there is a higher risk of persistent headaches and more intense migraines in people who have gotten sick with COVID-19. 

Getting vaccinated is a safe and effective way to protect yourself against COVID-19 and help end the pandemic. If you have any concerns about vaccination and how it may affect your migraines, please contact your general physician or migraine specialist.