Wednesday, January 8, 2014

Spinal Joint Injections and Me

So Monday, thank many many Gods, was my last facet joint injection. Plan-wise, the last of three in this round. If they're successful they'll be repeated every few months. And that is assuming they are godDAMN successful, because this experience has been at its best very uncomfortable at its worst excruciating.

For most patients, I understand it's not a big deal at all, so if you're ever undergoing this treatment be assured my story is (as usual for my medical situation) atypical. Dr. B administered the shots and coordinates my pain management. He thinks my spinal cord stimulator hardware is the reason it was so hard, but it seemed to have to do with my pain level on the day I got the injections. Monday I was in a good deal of pain and the shots were awfully painful. The middle one was disagreeable but not even really painful.

The treatment is for arthritic pain, which increased for me dramatically last year. They can do these in different affected joints, and the joints they use in the spine are the facet joints. These are like little bumpers between vertebrae and at the base of the spine between the vertebra and sacrum. That joint is called L5 S1 and is the level I had fused in surgery in 2011. It occurs to me writing this  now that that history likely played into my fun hypersensitive butt. Here's my rendering of the joints they treated. I highlighted three but they injected both sides.

Facet joint surfaces remind me of the little nose pads on metal eyeglasses.
If you're sensitive to reading graphic descriptions of medical practices, you may want to skip to the last two paragraphs.

So here's the rundown of the procedure: They have me lie belly-down (which sucks if you have low back pain) and hike my pants down until my butt is exposed to the top of my crack and wedge my shirt up under my bra, then cover my clothes with sterile sheets and disinfect the skin. A tech positions an x-ray to help the doctor find the joints. He marks the injection spots with a pen then numbs each area with lidocaine. The needle is tiny but the medication stings. He lets that take effect then inserts a sort of IV tubing that will guide the steroid medicine into the bone. This is the worst part. The puncture is totally painless but as the needle penetrates into my angry, angry soft tissues it is vile pain. I can't really feel when it hits the bones, though at the end it's worse. Then the doctor wiggles the fucking things around to position them optimally and two of three sessions I just curse in a mantra of fuck fuck fuck from this point until the end. After the needles/tubes are positioned he injects the cortisone, which hurts differently but I seem to have reached maximum pain so this is irrelevant. (However, the first time he said we were almost done when he was finishing the last needle positioning. This was true, but then when he said, "OK I'm going to inject you now," I was devastated.) The actual injection is over quickly, and the nurses help me adjust my clothes and have me sit in a rolling chair and move me to a short check up in the recovery area. By the time they give me a Coke and check my vitals I no longer feel the shaky faintness of an adrenaline crash and I ask the nurses to please convey my apologies to the assistants for my swearing.

Afterward there are tiny pinpricks that look annoyingly like nothing.
And it feels at the time like they are treating a huge chunk of my low back
but it's actually just six little spots between my tramp stamp and my butt crack.
The procedure takes such a short time that if it does help that deep ache in my hips and the stiffness in my waist and back then it's a pretty easy judgment call. Although it's whine-worthy awfulness it's over in minutes so I can handle it. It does seem like this crazy-frigid cold spell brought less bone pain than it would normally, so I'm inclined to think this is helping. It's tough to quantify pain relief, though.

My next medical posts will be far less squicky, I promise. My Facebook friend Jane wants to know "what does an anatomical non-comformist do?" and I've been planning for oh, two years or so to complete the story of my birth defects by explaining all those vague allusions to reproductive organ oddities. So there are some more Body of Weird posts on the way.

Stay warm and be well, loves.


  1. Oh lover I have been doing these exact sameinjections for 5 years now with the addition of cervical ones too. I have avoided surgery so far but my L5 has pretty much disintegrated now. How do you like the spinal nerve stimulator? I'm contemplating that now. I'm also using fentanyl patches because I have absorption issues. I'm ecstatic not to be using a freaking walker anymore. I will say though my injection experiences were not as severe as yours. I had a rhizotomy this past November and that seems to be working well so far. :-)

    1. Oh, honey, I had no idea you were dealing with this. My heart is with you. I love the stimulator. It's really helped with the neuropathy. It doesn't affect the muscle pain or arthritis, but the new injections help with the arthritis.

      Wishing you health and much improvement! Blessed be:D