fluoroscopically guided spinal injections

I have had Botox in my lower back to block the nerves. I went from that to a rhiztomy where they burn the nerves so you I longer feel the nerve pain. For me it last about two years. I have severe arthritis in the SI joint from an actebulum fracture in 2010. It causes a lot of pain. They ( orthopedic surgeon) have talked about fusing the SI joint. It is a common problem with the fracture.

@rybren Back issues run throughout our family, I have issues L-3 to S-1 and like many in our 70's, constantly deal with lower back pain. Local hospital has a pain management dept. In Aug of 2019, said yes to a once a month shot for 3 months. Done in an outpatient setting, this was a a pain killer and lidocaine. Short term, 3 -5 days, it helped but not long term. I would consider what I had done for needed short term relief (wedding, vacation), Years ago, my suspicion was the back issues was causing my drop foot and sensory motor PN. In 2018 and 2019, went to 2 neurosurgeons who suggested these nerve blocks as a sort of test to see if any long-term relief would take place. Both high level neurosurgeons refused to operate. Both felt my lower back issues were not the direct cause of my PN, confirmed by Mayo 4 years ago. Like any outpatient procedure, there are risks so best to drill down on any negative aspects based on current health.

These type of facilities are usually a "cash only" place. Or, they will glady arrange financing for you to pay off the cost of the procedure over time. Check to see if that is the case. I would hate to see you spend a small fortune on a procedure that does not work (and, you know that there are no refunds).

I had 2 fluoroscopy guided injection in my spine and my pain went away. I had on and spinal stenosis in several places. It’s been about 6 to 7 weeks now still no pain. I was told it could last from a few months to a year. Best I’ve felt in many years. It was done on an outpatient basis, lidocaine, injections then home.
Note- I had a single unguided injection, maybe a year before but to no avail!

Back in 2016, I had a whole bunch of those, all up and down my spine and S/I joints. It was over something like a year. Now this was at a Pain Management clinic, that used the facilities at a local hospital to do them. I'd had a few before that, up in Alaska, and it was just in a small clinic, room set aside for it.

In every case, the Pain Management specialists were specialized Anethesiologists. I lucked out in that the first clinic I had one in was set up and manned by a former Professor with the University of Washington's medical school in Seattle. She explained quite a bit to me, when I was transferred to her before leaving Alaska. I arrived in an inhumane amount of pain, and no relief for years from it.

I have no complaints about any of them, except one, but that was not his skill or treatment. The course of injections (all steroids with lidocaine sometimes too) was determined to be too much steroids in late 2016, by the supervising doctor over all the other pain management guys. They shifted me to chiropractic, only they told the chiropractor what he could not adjust, and then found him for me. It was a truly great practice, it's changed some, I moved away in 2017. But it goes by Lynx now, in Tri-Cities, WA. Most of them were effective, some more so than others. My brother has had some and none of them worked for him.

Then, I had one epidural steroid injection recently to L5, again by a specialized anesthesiologist. It was nothing I was prepared for. They rolled me back to a curtained off room, and had me pull down my pants in back for the doctor. That should have been my first (or last clue). It felt like he was literally pounding that something (the needle?) into my back, and he hit it one time too many and it punctured my lumbar spine. Okay. It happens. Fine. He admitted it first to the nurse, giving her instructions I was to stay flat, and he apologized to me, and told me I was going to have a "really bad headache" which I did, but not right away like he said, it took 20 minutes or so. They laid me out, and lifted me up carefully, then back down. Over and over again. Still, I was okay with it. I had a bed at home to go to, and my daughter to take care of me. However, that doctor had taken me off of all NSAIDs for weeks ahead of time. He'd prescribed Cymbalta, diagnosing me with CFS, but I had to go off the herbal antibiotic (an MAOI) for an unknown amount of days before I could even start the Cymbalta. And my PCP had also taken me off of all NSAIDs until I saw a kidney specialist and was okayed again to use them. That was scheduled, but I had not been able to do it yet.

So, even though I asked for pain meds for that day post epidural steroid injection to lumbar spine, and/or to have at home for the next 24 hours only, the nurses (only) prescribed me Tylenol. Doctor prescribed me nothing, yet was telling me I'd have a "really bad headache." I have so many other painful parts, from other conditions like PMR, avascular necrosis, prominent epidural fat in my lumbar spine (it impinges) that I take the maximum Tylenol, everyday of my life, already. They would not even hear of me asking for pain med while I was right there, under their care! And here's the best part, I have no record of ever having abused, misused, or having been dependent on any controlled substance. I was raised by a nurse, we were taught right about that.

I got one bad one out of a really good run of good ones. Make sure, if at all possible, it's at least an anesthesiologist or resident one working directly under a specially trained anesthesiologist. We're never going back to that last one I had. But they are not all bad, not by a long shot.

After a lumbar laminectomy 2 years ago, I still have radiculopathy pain caused by some remaining compression on nerves after they exit the spinal column. I have been going to a pain clinic every 4 months for the past year to get injections near my spine in that area. The doctor uses a fluoroscope during the procedure to help guide the needle to the best spot for the injection. The procedure usually takes about 30 minutes, and I am free to go afterwards, though my wife has to drive me home. Sometimes the injections help better than others.... and last a bit longer than at other times.... So I believe that it is typical for a pain doctor (mine is an anesthesiologist) to use a fluoroscope to help guide the needle. I would ask my PCP for a referral to a pain management clinic... someone he has had experience with in the past... rather than just going to someone I saw advertised... but that's just me. Hopefully your doctor knows of some pain management clinics in your area. Best wishes! Mike