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Low back pain from arthritis we think

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Posted 11/19/2011 9:29 AM (GMT -5)
I've only been dealing with this for 3 months.  I have low back pain and pain that radiates to my buttocks and upper backs of my legs especially when sitting.  Riding or driving the car is excruciating.  We first tried 4 weeks of physical therapy which didn't change my pain level.  4 days ago I had a facet block that so far hasn't produced any change.  My pain doc has be scheduled for another block on 11/30.  He said if I got some relief from the facet block he would repeat it.  If I got no relief he would do an epidural.  Right now I'm taking lortab and icing, doing my stretching exercises I got from physical therapy.

Most people I read about with lower back issues have problems with their discs.  That where I'm different.  I'm 50 years old and they say my discs are very plumb for a person of my age.  The only thng showing up on my mri is arthritis in the facet joint area and mild scoliosis.

I thought the facet block was painful even tho they gave me versed.  They stuck me 6 times.  I'm wondering if the epidural is about the same?  Thanks for listening.

Posted 11/19/2011 11:07 AM (GMT -5)
Hi Ikd,

Welcome. I too have mild scoliosis (about 20 degrees) from C4-T4, and among other problems, also have facet arthritis in that region... and get a lot of pain from it.

In my case, though, the pain is only on my left side (concave curve).

I had an epidural in my cervical spine last year... just one injection in my case if I recall correctly. Doctors may inject at multiple levels or just the uppermost, letting gravity bring the medication down.
Posted 11/19/2011 11:09 AM (GMT -5)
Welcome to the forum Ikd,

I've had facets, epis, caudal, ablations ... To me, the pain is about the same for all. The local anesthetic stops the sharp pain. All that's left is some ouchy dull pressure-type pain.

Versed does nothing for pain. It just helps you relax in small doses; it's used to give you amnesia for the event in larger ones. I won't take it. I know what's coming, prefer to have a clear mind.

Arthritis can push on nerves and cause pretty bad pain. I've had lots more of that since being in a wreck. I've got scoliosis too, but that doesn't seem to be a big problem.

I get some relief from tramadol, also a TENS unit because a lot of the pain is from muscles along the spine. The radiating pain I get is from spine, and some of the injections, especially at L5-S1 or caudal, help that for a while. My muscle pain beside the spine feels different, but it's no less painful.
Posted 11/19/2011 4:40 PM (GMT 0)
Hi LDK and welcome to the forum. I am sorry to read that you are having such a time with your back. I am with you, the facet blocks do not feel all that great and were painful. I have problems at the L5/S1 facet joint and it can really deal a person a lot of pain. I did not get any relief with the facet injections and after doing two I said no more. The way I saw it, it was not helping and why subject myself to more pain for nothing.

The one thing that did help me was a script of Medrol Dosepack. It is a steroid and you take so many pills the first day and taper down to one pill at the end. The pain you describe in your buttocks and the backs of your legs sounds very much like nerves that are inflamed. Thats where the steroid comes in and calmed those nerves by reducing the inflammation. This may be something you can discuss with your dr.

Are you seeing a specialist or your primary care physician? Is your dr willing to give you anything to take for pain relief?

You asked about the epidurals and a lot of it depends on the tech doing the injection. Some people say they had a great deal of pain and then others say they didn't. The epidural is one injection repeated usually 2 times spread out over several weeks. Again, its the pretty much the same no one can tell you if you will get any benefit from it or not. It may or may not help you.

I hope that you can get something done soon to give you some relief. Please keep us posted on how you are coming along Take care.
Posted 11/19/2011 1:59 PM (GMT -5)
How much pain you are going to feel really depends on the doctor doing the procedure and also in part on how well the patient communicates how they are doing.

A truly compassionate doctor will ask many times during the procedure how you are doing and if you find the pain level of what they are doing too high the doctor will provide more pain medicine.

These procedure really should only me moderately, or even highly uncomfortable instead of actually painful. Sometimes they might actually hit a nerve or something when going in which can cause a sharp, quick pain that usually subsides with in moments.

This is all during the procedure. Sadly it is not uncommon to have pain levels increase anywhere from a few hours to a day later which normally last a 1-3 days before subsiding. This is due to the medication they inject putting extra pressure on the area as well as irritating the nerves. It also often takes anywhere from 1-2 weeks before you know if the procedure is going to work.

The main reason many people report feeling better right after the procedure, even up to a full day after, is because they are still feeling the effects of any sedation and/or pain medication given during the procedure.
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