Nerve Blocks for Herniation in L5 S1

[canadianinpain]

I have been in pain since Jan 1 of this year.  Pain at first was only in my back but by March I was having extreem pain in my left buttock and down my leg into my toe.  I have had a CT Scan and an MRI and have a disc herniation that is out 1.5 cm and up 1.2 cm in my L5 S1.  I don't know if this is a more serious herniation or not but I haven't even seen a specialist yet as the wait list is soo long.  I have an appt for the end of Oct.  witch will make it 10 mos. since I have been in pain.  My family dr had me on oxycontin starting at 40mg a day and by the time I stopped taking them was up to 120mg a day.  That was 10 days ago.  I did some research on my own and went out of province to a private clinic to pay for a nerve block.  I had that on Jul 19.  I am still in pain and have contacted the clinic again and they booked me another appt. for Aug 20 to have a second nerve block done.  My question is that if it didn't work the first time, will it work the second?  It is costing me alot of money and I have tried physio and massage as well as accupuncture and it didn't help at all.  It accually made me worse.  I am at the end of my rope and don't know what to do.  I do not want to go back on the pain killers but right now I am soo bad that some days I can't get out of bed by myself.  If anyone can offer some advise that would help me it would be greatly appreciated.  

[MamaAng]

I am so sorry you are suffering so much and for so long.  It is incomprehensible, living in the US, to me that you have to wait so long.  My herniation is very large and I see an orthopedic surgeon tomorrow (8 days after my small bulge on L5/S1 became a large herniation that is sitting ON my sciatic nerve) and I feel so blessed to be getting in that soon.  I am not convinced that having surgery is the answer and it will take a few months to get in to see a neurologist for a second opinion but that is nowhere near the length of time you are having to wait...and suffer.  My heart truly goes out to you.  I hope that you can find something that gives you relief.  Being allergic to muscle relaxers and most narcotics makes things that much harder for you and I suppose if that was my situation I, too, would be anxious for surgery.  (((hugs)))

[Tuckamore]

Hello and Welcome to the Pain Mangement Forum. I apologize for my tardy response. I've been having some computer issues. I am so sorry to hear about your pain and the very long wait our neighbors in Canada have for medical care.

Your first question regarding a steroidal injection. I have had just two. The first one did provide some releif for a few weeks. The second one was so painful I refused to have a third. Both were done under fluoroscopy by a the same very skilled physician. I cannot tell you the differance from injection to injection. It's just the way our bodies respond.  

If you are tolerating the pain now without a narcotic it would be my assumption that the injection has some benefit. But only you know your pain levels.

I have tried a TENS Unit. It did nothing to alleviate my pain. That does not mean that it hasn't worked for others or that it won't work for you. When you have chronic pain I think any thing that can't hurt you if worth a try. It's a non-invasive treatment that may be effective in reducing your pain. The theory is that the electrical impulses confuse the pain signals that your affected area sends to your brain.  

Yes I would imagine that any surgical procedure in the US would be very costly. We do not have the unforgivably long waits that your country has....but we have unforgivably high costs. Some ppl without insurance in the US are denied these procedures so I don't know which is worse in the long run.

Thanks you for posting. I hope you will be active in our community. Feel free to ask additional questions and to respond to other posts. I'll look forward to hearing form you again and wish you the very best.

Take Care,
~Tuck

[canadianinpain]

First to answer your questions yes they did use fluoroscope with the injection.  The dr that did it was an orthopedic surgeon that works at a private clinic in another province.  He can not help me further than the injections and I have to wait to see a specialist here due to the fact that private clinics do not do most surgeries in Canada.  They are done through medicare at gov run hospitals and this is the reason that the wait is so long.  It has to be done in your own province if it is availible there.  No matter what the wait.  I also had a huge problem with the language barrier as I am english and the clinic was in a french province.  I accually started taking lyrica yesterday but only 25mg before bed.  The way they have me on it i will be up to 200mg a day in 3 weeks and then that is where i will stay for now.  It was the dr at the clinic that prescribed it to me but told me to wait for 2 weeks before I started taking it to see if the nerve block worked first.  Right now i am living on no pain killers at all as I am allergic to most and the withdrawl  off the oxy was so bad that I do not want to start taking it again unless I absolutly have no other choice.  I don't think that I have any more pain from the injection but it is hard to tell as before I was on a heavy dose of pain killers and now I am on nothing so it's hard to judge what the oxy was covering before.  I was tried on 4 different muscle relaxers and had allergic reactions to them all.  The last one landing me in the hospital.  I am so frustrated as when i got the call for my appt with the specialist here his receptionist told me that I was semi urgent which means that I do require surgery for sure but I don't require hospitalization untill the surgery so that I olny have to wait 7 months to see the surgeon.  He has already seen my MRI and CT Scan and that is how I was rated.  Also the wait list here for surgery with him is 1 1/2 - 2 yrs and you do not get put on the list until he has seen you so the 7 months that you wait to see him even though he has pretty much decided that I will require surgery, I feel have been wasted.  I have looked into going to the US for surgery but was told that it will cost upward of $30,000 and even though we have insurance through my husbands work, they will not cover anything out of country if it is availible here.  I just have to wait.  There is a pain management clinic here and i am on a waiting list for that too.  I will get in around dec of this yr.  Yes, it is wonderful that Canada has free health care but it seems like free means waiting forever.  The GP that I have been seeing since Jan for this doesn't seem to know what he is doing so that leaves me stuck too as there are no other dr's where I live.  i have even looked into surrounding towns and cannot find one that is taking new patients so for now I am stuck.  BTW  what is TENS?  I have never heard of it.  Thanks for answering me

[MamaAng]

Did they use fluoroscope with the injection?  What kind of doctor did you see?  Was it a LESI?  I have had 6 LESI procedures in the past 2 years.  The first 4 worked without incidence.  The last 2 have been nightmares.  Increased pain for a week afterward.  This last injection, not even 2 weeks ago, left me in a lot of pain and on top of it I herniated my disk further causing a severe acute event.  My point is, every injection is different.  I started out on Hydrocodone and was on it until last week when I was moved up to 15mg of Oxycodone 4/day with Flexeril (muscle relaxer) and gabapentin (nerve pain med).  If you are not on gabapentin you really should talk to a doctor about it.  It really, really helps the nerve pain.  I am concerned that it is taking you this long to see someone.  That is outrageous!  From my first herniation to my first injection was 9 weeks and I was on hydrocodone from my PCP in that time.  I am so sorry you are so miserable.  I know your pain, I know how hard it is to get out of bed in the morning.  I was barely functional on just hydrocodone.  The only thing that made me a functioning human being was the cocktail of meds/inj/TENS/etc.  Is there a pain clinic in your area?