Facet medial branch blocks - take two

[annapurna]

Just had my second round of facet medial branch blocks yesterday - this time with a longer acting local anesthetic. Looks like the left-side facets are responsible for some of my pain, though not all of it. I estimated a 50% reduction. I would like to consider rhizotomy since that 50% reduction "felt" very significant in how much I want to move and do things. On the other hand, I had some sort of motor-control problems with the injection that made walking a bit difficult, and I'm scared that the rhizo, which is semi-permanent, could cause the same problems. I'm also back to the old question of whether I should pursue a pain management technique just so that I can exercise and participate in sports. I've always been told to "listen to my body" and only do the things that don't hurt. Unfortunately, EVERYTHING hurts now. My "body" is saying it wants to curl up in bed and take narcotics all day - not acceptable to me. Any rhizo veterans or anyone else have any thoughts?

[Jim M2]

Gosh Laura, it seems like experimentation with a slower, less strenous lifestyle is worth a try. It dosen't sound like the pushing it was meant to be. Be conservative. What if you mask the pain and really hose things up? You've then painted yourself into a corner. You'll have no where to go.

If you get rhizo'ed every year and it works over the long term that would be great. If you rhizo'd and it got worse you could fuse as a last ditch effort, hoping for the best.

I'm none too happy to see you reporting these problems. My improving situation leaves me with symptoms similar to yours. I had the ugly pain that has been slowly receeding over the past several months. What's left is mostly bilateral, motion dependent soreness around the L5S1 level. There's also general acheness, stiffness and soreness surrounding the area. It's very much dependent on activity types and activity levels.

So there you have some rambling thoughts.
Take care,
Jim

[ans]

Laura,

Are you amenable to exercise using body-weight, etc. that doesn't put pressure on your spine and aerobics like swimming, aided by a device like this? http://www.hydrofit.com/catalog.html?product=belts

It's second-best but an adaptation that would offer you optimal aerobic condition and tone everywhere.

Best Regards, Allan

[annapurna]

Thanks again for the help. You've both brought up a question I've been struggling with for the last year or so. How much physical activity is prudent and sustainable? As much as those who know me will not believe it, I've actually tried a dramatic reduction in physical activity these last two months. On the emphatic advice of my therapist, I gave up swimming, cycling, hiking, spine stabilization exercises, and weight training for two months. I took short walks on flat ground, did swimming-like water exercises with my arms only, wore a brace, and spent the majority of my time sitting at my desk or laying in bed. She felt sure that if I just gave my body a long enough time to "recover and heal" that I would feel much better. Well, it's two months later and I have more pain that I've ever felt since I got my ADR. I'm really disappointed because I had to use so much discipline to say "no" to all the things I love to do - not to say observing a rigid diet to keep from gaining twenty pounds. The only thing I have to show is more pain, visibly less muscle, and a growing feeling of frustration. It's hard to believe that as little as six months ago I was XC skiing twenty miles in Yellowstone with a thirty pound pack and zero back pain.

I'd be willing to try anything, including a month of complete bed rest, if I could be convinced that there was some pathology that it would rememdy. The "do less and you'll feel better" approach hasn't worked yet for me, but, then again, maybe I just haven't given it long enough.

Thanks for the input, and sorry for the whining.

Best,
Laura

[ans]

You're not whining Laura. You're used to a high-end life and it took you years to get into such condition.

Have you considered seeing a "big gun" in LA e.g. Bray, Regan, or Delamarter for a consultation? Best, Allan

PS I'm amazed how much you did only six mo. before surgery.

[Mariaa]

Laura,
May I ask how soon after surgery you resumed an active lifestyle if at all? I'm just wondering if there was a particular point at which you felt or noticed the pain starting or was it right after surgery or a gradual building up of this pain?

After my 2nd spine surgery, I was Ok for about a week but then I decided I better start back exercising as I was slated to return to work 2 weeks after surgery (tho had a 6 week period I could be off).. long story short, was on the lifecycle and after a while I felt a very weird feeling of "collapse". I just about jumped off the lifecycle but the damage was done and the pain continued and worsened.. it spread thru out my buttocks and legs (was deep burning and gnawing) with a heavy pulling sensation at the tailbone and low back pain.

This pain went on for 5 years full blast and was relentless~ really terrible. My lifestyle before surgery was limited episodically tho after this surgery it was chronically affected and the bed and I became best friends~ ugghh.. practically anything brought the pain into a full flareup and I could bearly work part time..
Drugs.. wasn't even offered anything that would touch this pain the way the drugs do today~

I know everything is different in terms of pathology with what occured after this surgery and yours however, I always wonder had I not resumed activity so early would this have occurred...(and wonder will it occur again as it's this type of pain and any new addition of pain that I can do without).. unfortunately hindsight isn't worth diddly squat!