Nerve blocks - pros and cons?

[David Wang]

I'd like to get some views on the pros and cons of epidural steroid injections/nerve blocks etc. I have a feeling that the surgeon (I'm due to meet with soon) might recommend that I try an injection first, before considering surgery. I know someone who's had this and had enough relief from their sciatica pain, to be able to cancel surgery (for now at least)

Some might say it has to be worth a shot (excuse the pun) even if the chances of recovery are slim. My main concern is that it could delay surgery in vain, and that by delaying surgery, my chances of successful surgery are significantly reduced (there are several reports of a window of opportunity for surgery, for the best outcome. i.e don't wait too long). Not to mention the various risks (possible complications etc) associated with the injection.

What are your experiences with nerve blocks/injections ?

 

[preciousAngel]

hi, i have no experience of nerve blocks, is it a disc problem you have because i had L4/L5 done a year ago i was waiting 9 months for the op but i was then left with nerve damage so in my experience the longer you wait the more damage can be done to the nerves, i would think with the nerve block the problem is still there its just you cannot feel it ,good luck with your decision.

 

[naguero]

Your surgeon should be able to tell you this.

Firstly with any procedure he should be able to tell you why he thinks you need it, how he hopes you will benefit, and what are the chances of success.

Secondly, you are entitled to a full disclosure of risks to which you may be exposed. Under the Ashfar Ruling any adverse result, from a procedure, that is considered possible should be mentioned, even if the likelihood is very remote.

Many people forget to ask for this information, and although it probably should be volunteered, it may not be in the forefront of everybody's minds.

What you might not be told are peripheral risks, such as consequences of misdiagnosis, accident, infection or injury whilst in hospital, drug errors etc.

It may seem premature to discuss this until you know what is proposed, but I think you are asking the right questions, you'll be more likely to come away from your meeting with the answers you need.

Otherwise, from a natural healer's pov, going down one route can make it harder to help in other ways. It will be no less the right thing because of this, but there may be other effective options worth exploring whilst on the waiting list.

As BMW1 has pointed out steroids and anaesthetics don't actually solve the underlying cause of the problem, so I think what you are looking at here is possible relief from symptoms.

The stakes are usually quite high with surgery, and because it is generally irreversible, I would think most people here on HP probably consider it to be the last resort.

 

[Shrike]

Hi Jim,

First of all - additional diagnostic methods like selective nerve block or any type of infiltration is welcome to confirm the diagnosis. However, they all carry significants risks. For example infection or dural tear (with ESI).

The truth is - many people go for blocks to buy time. And then, big percentage of this cases end with NO surgery at all. Recently I attended a seminar where few MISS surgeons presented this.

You can give it a try, be sure to go for experienced spinal surgeon and be sure infiltration is done with fluroscopic guidance.

 

[John Victor]

Hi Jim100

I treated a couple of days ago a 26 year man who a few weeks ago had a nerve block performed at L4 for diagnostic purposes. He is still in pain. So I give him a deep tissue massage with passive stretches and mobilisation to the back and legs. 1 hour later he walked out pain free. How long this will last who can say, but he has seen consultants, physio's and chiro's with very little effect. No one bothered to check his hamstrings or IT band or glutes which are spasming - the body trying to protect itself after a serious car accident 6 years previously.

What I'm trying to say Jim is have you tried other therapies? Even if the epidural works for a while, the problem is still there. Not knowing your case, therefore cannot comment, but most pain in the body is often the result of contracture of the soft tissues, and this is where a combination of massage, manipulation and exercise is advantagous.

Best Wishes

RP

 

[daysXofXinsanity]

Jim are they still offering injections? I thought that the new NICE guidelines had removed that possibility? Likie Keano said make sure they do it right not just stab in the right general area, they need to be pinpointed to work properly, and it always concerns me that when they do work, the patient then may go on to do more damage faster as they are not pain restricted? They do not heal they just remove the pain, which of course is great but, see what I mean? Don't then go and run a marathon or even bend down etc

 

[IeeDrv]

I'm afraid Cassie that NICE guidelines cannot be relied upon as indicators of normal practice.

(Illustrative Example: On the subject of giving controlling fever in children:

NICE guidelines (extract): "Antipyretic agents should not routinely be used with the sole aim of reducing body temperature in children with fever..."

NHS Direct website: "You can usually treat fever in young children at home using infant paracetamol." and "Treat discomfort and fever with paracetamol or ibuprofen".)

 

[Bobbie L]

What are your experiences with nerve blocks/injections ?[/quote]


Hiya Jim.

I have had '4' nerve root block injections in my lumber spine in the last 5 years, 2 at L2/3/4 & 2 at L4/5/S1 levels without any complications.

The 2x L2/3/4 injections failed to have any effect, because the Surgeon completely miss-diagnosed and mis-treated my condition, inspite of clear presentaion of contra-indacations.

After correctly diagnosing myself and providing medical evidence to prove the same, I recieved 2x injections at my L4/5/S1 levels and were completely successful, because this time they were in the right place!

The period of benefit was; 6 weeks of complete pain removal, followed by a further 5 weeks of reduced pain and spam levels.
2x 11 weeks in total, totaly worth it!!

I've got to go now, but I wil come back to this thread shortly.

Best wishes

SPINELF