Facet Joint Injections 5/12/16

Many of you know that I have been suffering from occipital neuralgia for several years, and have tried everything from physical therapy to acupuncture (you can read more about my acupuncture journey here) to trigger point injections to facet joint injections.

The next step is a procedure called a radiofrequency nerve ablation (here is a medical link that explains the procedure). Basically this means that I will get the nerves in my neck burned off...it sounds way worse than it actually is, at least according to my doctor. Here's the catch, in order for medical insurance to pay for the radiofrequency nerve ablation, I first need to have two identical, successful facet joint procedures done.

I had my first set of injections done in Nov 2013 (which I documented here, here, and here), and another done just a few weeks ago. The first time I had facet joint injections, the procedure almost gave me a panic attack, I was pretty sore for many days after, and they didn't give me the lasting pain relief that I had hoped for. I did not want to try them again, even though my doctor wanted me to give them another shot (pun intended!).

The problem is that the facet injections I had done a few weeks ago were done at different points in my neck in hopes that I would get better results. And the results were better this time around, but the pain relief only lasted about a week. Doc says that as long as I got relief, even for a short amount of time, that the chances of the radiofrequency nerve ablation neck procedure working are much better. That really is a mouthful.

So, today I go for my second (even though it's really my third overall) round of facet joint injections, in the adjusted spots. Wish me luck! I'll try to document these and report back. The really short version of the procedure from a few weeks ago...I was sore for a few days, but overall it was a much easier procedure (less painful) and quicker recovery. My doc prescribed valium for my anxiety, which helped a lot, and I have another prescription for today's visit :) Let's hope the relative ease of last time wasn't a fluke and I get similar results this time!

New Pain Medicine Routine

I don't know why, but over the past couple of weeks my arthritis has really been flaring up.  I've lost a lot of sleep and finally got tired of feeling so terrible.  My doctor that I see for my neck pain had originally prescribed this new medicine and I decided that I should give it a try.  It's a non-narcotic pain med called ConZip, which is really a slow release Tramadol.  I've been using it for my overall arthritis flare ups and it helps take my pain from a 5-6 to a 2-3...which is a huge difference.

I still get localized pain in my ankles if I'm on my feet too long, and in my neck/shoulder area because of my occipital neuralgia.  For these areas I have compound cream that has been helping take the edge off.  The cream I have for my ankles is a bit stronger and I'd like to try it on my neck, but it's super greasy.  After twenty minutes of absorbing into my ankles, I wipe it off with a wet washcloth otherwise it's too sticky to even get my socks back on.  I'm afraid of getting it into my hair and not being able to get it out if I try it on my neck...I'd have to be super careful.

Ankle cream ingredients

side note:  When I got my new ankle cream a couple of weeks ago it came in some very impressive  packaging.  There was a cold block in there (I guess in case it got too hot during shipment) and it was cushioned to the max.  Seriously, look at the big cushion that was in this thing.

The cushion was bigger than my 10 year old...

Also, I got 3 containers of it.  Does it get used that quickly that I need this much???  I guess we'll see.

Anyway, this has been the routine for about two weeks or so.  ConZip in the morning, Celebrex (anti-inflammatory) and Soma (to keep my back spasms at bay) at night...and cream on various body parts as needed.  It has helped keep the pain in check enough that I was able to take part in cleaning the house in anticipation of my family visiting, and I was able to enjoy the time with my brother when he was here last week.  Let's just hope this all continues to help and that I don't die of kidney or liver failure by the time I'm 50!

My Neck Is A Pain In The Neck

Since I've been struggling with neck pain again over the past three weeks or so, I went to my pain management doctor last week and got some simple lidocaine shots in the trigger points in my neck and upper back.  This helped a little...I was hoping it would help more than it did, but it did take my pain down a notch on the ole' pain scale.

Since I'm still going to physical therapy for my ankle, I asked my therapist if she could “wand” my neck.  I forget the name of that thing all the time, so I call it the wand...sonic...ultrasound...I don't remember...THE WAND.  Anyway, it's a machine with a wand attached that they rub on a small part of your body and it acts as a deep heat sort of thing.  This helped bring my pain level down another notch...so now my pain is at a 3-4...which is still painful, but doesn't usually stop me from going about my day...I'm just a little more grumpy about stuff :)  My pain doc also gave me a prescription for physical therapy on my neck, so this week my therapist did some hands on massage of my neck, right at the base of my skull.  This helped even more. Down another notch!  Now I'm in “reasonable pain I can live with” land...at least in my neck.

Hopefully, I can keep it down like this for a while longer, otherwise I have to go back to my other doctor for some steroid shots into the neck/occipital nerve area.  At the end of November, before I had my ankle surgery, I went for facet joint injections, hoping they would help calm all this pain down for a while.  And by a while, I mean longer than 3 months.  I was hoping to get 6 months to a year out of these. Notsomuch.  So I think when I do have to go back for steroid shots, I'm going to ask for the original kind I had for two years...shots into my occipital and lesser occipital nerves.  Those also lasted for about 3 months...but they didn't hurt as bad and I didn't get anxiety going in for those.

I blame all this on Mother Nature.  Seems like when we had that big snowstorm a few weeks ago, it set everything off.  I love winter, and I love snow.  But as I get older, I'm loving all this pain that comes with it less and less.  I think I just need a Disney vacation :)  Hello sunny Florida!

A Pain In My Neck...No More?

I'm happy to report that my neck feels a million times better than last week.  Immediately after I had the shots on Friday my pain level went down even though I was still experiencing the pinching.  Saturday the pain was less than the previous day and Sunday was even less than that.  

My pain level was at such an acceptable level yesterday that I ventured out of the house and went to my in-laws to celebrate my mother-in-law's birthday.  Both my neck and ankle did reasonably well, although I was really wiped out by the time we got home and my ankle was aching a bit.  Nothing a little nap couldn't cure!  And I really needed it since I was sleep deprived.  As usual, the steroids gave me a bit of insomnia.  I usually can't sleep the night of the shots, but for some reason I didn't sleep Saturday night instead.  And my left knee started hurting on Saturday and is still bothering me today.  I swear this also happened the last time I had steroids....I'll just file that under "random weird happenings of my body" :)

So even though the pain was less, I continued to feel the pinching throughout the weekend.  Today, I have no pain in my neck and haven't really noticed the pinching.  My physical therapist did “the wand” on the spot where I was experiencing most of the pinching last week.  Hopefully that will help keep the muscles loose.  As far as medicine goes, I've been taking Flexeril 10mg, 3 times per day.  I took a Vicodin today...but that was because I was going for PT.

There is still a spot on the back of my neck where the skin is numb, and I'm still totally freaked out by this.  Anyone else with neck problems ever experience this?  Tomorrow my pain management doctor is back in the office and will let me know about the x-ray readings and we'll discuss if I still need to get the MRI done that I have scheduled for Wednesday.

Many thanks to everyone who kept me in their prayers...they worked :)

"Room At Arles" ~Vincent Van Gogh

A Pain In My Neck...Again

For the past week the right side of my neck has been hurting like crazy and my normal remedies (heat, massage, muscle relaxers) haven't been helping at all.  And the neck pain that I've been experiencing all week has been different than the pain I usually experience on the left side.  At first, I thought the pain was because of the weather since it started last Sunday when we had freezing rain, but after it didn't let up during the week I started coming to other conclusions.

In the past, the pain on the left side of my neck has been a burning pain that starts at the base of my skull and radiates down my neck, up my head, and across to my ear.  If you remember, I had tried an epidural injection and facet joint injections to help relieve this pain that was caused by the occipital neuralgia that I was diagnosed with two years ago.  (In case you missed it, you can read about why I have neck problems here).

This week, the pain on the right side has been very different than the left.  The right side has been a pinching pain and when it gets really bad it just feels like someone is stabbing me in the neck.  The pain also starts from the base of my skull (but on the right side) and radiates down my neck to my shoulder.  Also, my skin is numb at the back of my neck on the right side.  This numbness freaks me out the most.

The pain had gotten so bad mid-week that I started taking Vicodin Wednesday night.  I was kinda upset at this since I had just stopped taking pain meds for my ankle.  Oh well... I've also been taking a muscle relaxer since Monday to see if that would loosen it up.  By Thursday nothing had changed, and I had a physical therapy appointment for my ankle that day.  I was hoping that my therapist would have some answers.

I know that my neck muscles get tight and just assumed that I probably had some big knots that may need attention.  My therapist looked at it and said that it didn't feel knotty to her and that my facet joint felt a little off.  She was unsure whether that was “normal” for me, considering that I had surgery back there.  Instead of manipulating me too much, she did an ultrasound treatment on the spot where I felt the most pinching and told me that if the pain didn't go away I should see my doctor.

After coming home, I took a double dosage of muscle relaxers and a couple of pain pills (gee, I sound like a junkie!) and called the neurosurgeon that I saw two years ago to see if there was any way I could see him.  Instead, his secretary told me to see my regular doctor first, this way they could order any tests (x-rays, MRI's) and rule out if it is just a muscle spasm.  I had called my pain doctor for an appointment that morning, so I was already set.

I saw my pain doctor today and she shot me up with some steroids in the back of my neck.  It feels a bit better now, but the pain isn't completely gone and I can still feel the pinching.  She thinks that it's probably just a muscle related thing, but ordered an x-ray to be on the safe side.  She also said to keep with the medicine protocol that I had started...muscle relaxers and pain meds if needed.

We shall see how the next few days go.  I have an MRI scheduled for next week, but if I miraculously get better over the weekend than maybe I can cancel it.

Fingers crossed!

Update-Facet Joint Injections Day 3

Just a quick update... (for some background click here)

I can no longer start a bonfire with my face...happy day!

Morning

When I woke up, my face was no longer hot to the touch and I slept better too...no insomnia! I did notice that my knees hurt...this also happened the last time I had a steroid shot. Last time the knee pain lasted approximately 2 days, so I made a *note to self* to have my acupuncturist address this later on.

Mid-Morning Acupuncture

My acupuncturist did normal needle acupuncture and some bloodletting on each cheek, on my left jaw, and on my third eye area, in hopes of relieving the neck pain and face pain caused by laying on my stomach during treatment. I felt immediate relief after the bloodletting in my jaw. After my treatment, my knees felt better and my cheeks were flushed again and warm to the touch. This went away after a few hours.

Evening

My left cheek still felt warm to me...but not to the touch. My neck was still tender from where the injections were, and I felt like I had more energy this afternoon...but that could be from the acupuncture.

The best part of the whole day was the random act of kindness that was gifted upon me...you can read about it here.

Update--Facet Joint Injections Day 2

Yesterday was the day after I had the facet joint injections on the left side of my neck at the C1, C2, and C3 levels.  Read about the injections here.  My neck was pretty sore, as well as the left side of my face a bit. On a pain scale, it was probably a 4-5 by the end of the day.

At least my body is predictable, as I suffer the same side effects whenever I get any type of steroid injection.  This is the third type I've had...the others being: occipital nerve blocks, an epidural steroid injection, and now the facet joint injections.  The three worst side effects I suffered yesterday are:

• Insomnia
• Neck soreness
• Flushed cheeks

I stayed in bed all day yesterday because the night of the injections I suffered from insomnia, probably due to a combination of the neck pain and the steroid.  I was hoping to nap during the day, but my body wasn't too keen on that idea.  Oh, and I felt guilty that I kept my hubby up all night long...and not in a good way.

The neck pain was the worst in the morning and by the evening it turned into more of a soreness...like if you sleep on your neck all wrong and it gets kinked up...except a little worse.  I could move my head right, but when I tried to move it left it hurt.  The site of the injections were tender but not black and blue.

My cheeks were flushed when I woke up and my left cheek got really hot by the afternoon (approximately 24 hours after the shot).  I tried putting a cold washcloth on it, but it didn't help much. It was on fire I tell ya!  I thought my face was going to spontaneously combust it was so hot.  I took my temperature because I wanted to check and make sure I didn't have a fever.  Weirdly, my temperature was 97.4...even though my cheek temperature was probably a million.

Overall, I took it easy but was pretty uncomfortable all day.  The best part of yesterday was that I didn't wear a bra and stayed in my pj's all day.  So that was my "bright side" :)  Hoping today will be better.

Facet Joint Injections and Why I Have Neck Problems

So, I've been having issues with my neck and back for a few years now.  Basically, I have arthritis in my neck joints, and muscle and nerve related problems in my neck due to a cervical fusion I had when I was younger.

Why did I have cervical fusion?  Well, when I was first diagnosed with SED at 15, the doctors took x-rays of my entire body and concentrated on my neck and spine since it's common to have spine related problems caused by my disease.  And I was a winner (go me!) with a little bone chip that was floating in my spinal column high up in the C1-C2 area.  Looking back, there were some signs that we should have recognized.  I remember as a child going on bumper cars and getting bumped a certain way and having my entire body go numb.  Not good.  I also did a gymnastics class once and was doing somersaults and had my body go numb there as well.

The doctors told me that I was very lucky (I would say it's a miracle) that I hadn't been paralyzed (they said I would have been paralyzed to the extent that Christopher Reeve was) and sent me home in a cervical collar and I had surgery scheduled for 3 weeks later.  I had a halo put on about a week before my fusion and was in that for over four months.  I missed half of my sophomore year in high school.

Skip to 20 years later and my fusion has “settled”...like how a new house will settle after a few years.  Mine has settled and gone crooked.  If you know anything about how bones and muscles work together, than you know that your muscles try to protect your bones...and mine were getting very angry with my neck bones being crooked!  I constantly get knots in my neck and suffer from tension headaches.   It had gotten so bad that about 7 years ago I went to a neuro doc to see what was wrong.  It was him that told me that it was very common to see these fusions settle and get crooked, and the best thing for me to do was try to keep the muscles loose.  He recommended physical therapy and acupuncture (it was only years later that I finally started acupuncture).  I went to physical therapy for a few months and was able to get the muscles to a calm enough level and continued on with therapeutic massage after that about every 6 weeks (would have went longer, except that's a total out of pocket cost). 

This kept things at bay until about 2 years ago when my symptoms worsened and I was now also having constant burning down the side of my neck that would radiate to the entire side of my head into my ear and side of my face.  I went to a whole slew of new doctors and was really terrified that they were going to tell me that I needed to have my fusion redone.  Thank God that wasn't the case (seriously--THANK YOU GOD. Thank you, thank you, thank you!).  I was diagnosed with occipital neuralgia and started getting injections into my greater and lesser occipital nerves.  After my ankle surgery 5 months ago, my neck was flaring up again.  The doc who was doing my injections moved away and the new doc who replaced him wanted to try some new things that would hopefully last longer than the occipital injections.  I tried an epidural shot about 3 weeks ago that was supposed to help my neck and my back pain (yeah, I have some back issues too).   Not only did that not help, it was pretty painful for a few days.

And that brings me to today.  I called my doctors office to beg them to see me earlier than the appointment that I had already lined up for the end of November...I didn't want anything to interfere with my ankle surgery coming up.  They said they could see me this afternoon.  Woot!  The procedure I had done is called facet joint injections.  It was a bit painful at times and lasted about 10-15 minutes.  Most of the time the pain was about a 3 out of 10, with the worst of the procedure being about a 6-7.  They said that I should be mostly numb for about 2-3 hours and then I should ice it.  Well, it's been about 1.5 hours and I'm starting to feel sore and I have a very slight eyeball headache.

I was nervous about the procedure, having the epidural shot only weeks before, but I held it together pretty well.  I had a friend drive me (thanks Joan!) and I was glad that she was there in the room with me because after the procedure was over, I felt very anxious and thought I may have a panic attack.  I don't like needles in my neck!!  After a few tears, and a strawberry kiwi juice box (I guess that's what they give their nervous patients), I did my 15 minute wait in the office before I was okay'd to be released into the wild.

Now it's a wait and see if this works.  Fingers crossed...good vibes and prayers welcomed!

Anyone else ever had these procedures done?  Have they worked for you?  If so, how long did you find relief for?