Facet, Lumbar, & Trigger Point Injections & Spinal Stenosis

Discussion in 'Fibromyalgia Main Forum' started by JLH, Feb 20, 2006.

  1. JLH

    JLH New Member

    Lots of us have facet injections, lumbar epidural spinal injections, and trigger point injections; and have been diagnosed with spinal stenosis. Here is a study involving these -- just some reading FYI:


    Listed below is the outcome of invasive treatment modalities on back pain and sciatica: an evidence-based review.

    This paper summarises the currently available evidence on surgical and other invasive procedures for low back pain.

    Results of systematic reviews conducted within the framework of the Cochrane Back Review Group were used. Data were gathered from the latest Cochrane Database of Systematic Reviews 2005, Issue 2.

    The Cochrane reviews were updated using the evidence summary on surgery and other invasive procedures from the COST B13 European Guidelines for the Management of Acute and Chronic Non-Specific Low Back Pain.

    FACET JOINT, EPIDURAL, TRIGGER POINT, AND SCLEROSANT INJECTIONS HAVE NOT CLEARLY BEEN SHOWN TO BE EFFECTIVE AND CAN CONSEQUENTLY NOT BE RECOMMENDED.

    There is NO scientific evidence on the EFFECTIVENESS OF SPINAL STENOSIS SURGERY.

    Surgical discectomy may be considered for selected patients with sciatica due to lumbar disc prolapses that fail to resolve with the conservative management.

    Cognitive intervention combined with exercises is recommended for chronic low back pain, and fusion surgery may be considered only in carefully selected patients after active rehabilitation programmes during 2 years time have failed.

    Demanding surgical fusion techniques are not better than the traditional posterolateral fusion without internal fixation.


    ----------------------
    Eur Spine J. 2006 Jan;15 Suppl 1:S82-92. Epub 2005 Dec 1. Related Articles, Links

    van Tulder MW, Koes B, Seitsalo S, Malmivaara A.

    Institute for Research in Extramural Medicine (EMGO), VU University Medical Center, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.

    PMID: 16320030 [PubMed - in process]

    [This Message was Edited on 02/21/2006]
  2. marw

    marw New Member

    I don't agree with this. I recently met a man in my Physical Therapy, who had just received total relief after years of agony from stenosis with fusion. He could not bend all the way over to touch his toes. I ask him about that, and he laughed. Who cares? says he! I no longer have pain.

    This gentleman used the same surgeon I do. In my case I do not need surgery, but these back surgeons are experts, and they know what they are doing. I have been to several different back surgeons and not one of them would ever do surgery on my back. (I don't need fusion, but had wanted my disks fixed.) Turns out they were right, and I have been able to correct most of it through therapy.

    The point is that I am getting tired of hearing doctors bashed. I read somewhere where you said all they were was persons who were ambitious or had big egos. That is ridiculous! I studied Physiology and Anatomy in the same class with med students, and I can tell you that surgery, especially (but any specialty) is not only a highly developed craft, but a talent.....a talent in the same sense that an artist is talented. This is a gift. Granted one that requires hard work to develop, but a gift. Do you really think you can do what a surgeon does?

    If I have misunderstood, please accept apologies in advance, but I have great respect for most doctors. I know with FM it is hard to find a well-trained specialist, but it does not mena that all doctors are uncaring or lacking in ability.

    Respectfully,
    Maragaret

    P.S. And in case this opens any kind of controversey on this board, be forewarned that I have said what I had to say, and will not reply to any debate.

  3. JLH

    JLH New Member

    The above post is just an article regarding a study that was done .... some FYI stuff for everyone's reading .... to expose us to the results of different studies done, and not necessarily "my" opinion.

    I am happy that the gentleman that you met in P.T. got relief from his spinal stenosis surgery. I also have a bad case of spinal stenosis and my orthopedic surgeon said that I would not benefit from surgery at this time. I am OK with his decision. Everyone is different.

    I have also had a series of 3 lumbar edidural spinal injection that did not help my low back pain from various disk problems, etc.

    I wholehearted agree with you about getting tired of hearing doctors bashed. I especially feel that way because my own daughter is a physician!!!

    Regarding your statement that you read somewhere where I said that all doctors were was persons who were ambitious or had big egos .... Whoa!!! I think this is a misunderstanding!! I do have a post up now titled "How to tell if a doctor is a knight or a jerk" or something like that .... but this is just another article which I had read and posted .... one of those FYI reading type .... on how to tell if your doc is a good guy or a jerk.

    I DEFINITELY DO NOT PERSONALLY BELIEVE THAT ALL DOCTORS ARE PERSONS WITH BIG EGOS, ETC.!!!! What was said in that article was the belief of the author of the article--NOT ME!!! Again, my daughter is a doctor and has worked her little butt off for the last 12 years of college and residency, working 100 hours weeks, owing a couple hundred thousand dollars in college loans, and is sooooo dedicated and concerned about her patients. She is a "knight" and not a jerk.

    I personally have wonderful doctors that are treating me. I have run into a couple jerks, who I did not return to, but 90% of the doctors that I have gone to in my lifetime (and that I have taken my 3 children to) have been saints--giving 150% to take care of us.

    There is absolutely no need for an apology. I also have a real respect for doctors and agree that all doctors are not uncaring or lacking in ability.

    I hope this clears up any misconception that I am doctor bashing! Cause I didn't mean to come across that way!

    Respectfully,
    Janet

  4. marw

    marw New Member

    Hi Janet,

    I hope you will accept my most humble APOLOGIES for the post I wrote. It had been bothering me all week that I wrote it at all, so I went back just now to see exactly how I worded it, and sure enough, it is much too abrasive, and not even true in parts of it.

    I think I did not read the articles that you are posting carefully enough, and I do apologize. Also, although I said "you" I wasn't thinking of you, but just in general.

    You do a wonderful service here inposting all these great and informative articles for us. AND I WANT TO TAHNK YOU FOR THAT.

    Re the docs, even that part that I said is wrong, because of course there are docs that have big egos or are uncaring, just as there are the good docs who try so hard for us.

    Until I met that man who had liked his stenosis surgery, I too, thought it was not a good thing. I have stenosis also, and do not plan to have any surgery for it. For my disks, I can't remember if I said, but I had excellent result with a combination of epidural shots and Physical Therapy. I think everyone is totally different and each case would be different, and I'm sure you do too. However, I did find that the results, both from the shots and from the PT, depended on who did it (I think I mean whether or not they got the med into the right place.) I also found a lot of differences in PT, and was lucky to finally find someone to help me. I am losiong her now, however, due to changes in Medicare.

    You must be so very proud to have a daughter who is a doctor. I know I would be!

    I do most sincerely hope you will accept my apology, and forgive me for not being more careful before I sounded off, and for not adequately even reading what I was talking about!!

    I really am sorry. And I admire you very much.

    I hope you continue to progress in achieving remission, and that we all do, with the FM.

    Sincere regards,
    Margaret
  5. JLH

    JLH New Member

    Apology accepted; however, there was really no need for one, dear!! I was not upset, but just wanted you to know kind of where I was coming from!

    Yes, I am proud of my daughter. She has worked sooooo very hard to achieve what she has today.

    I will probably have to have back surgery at some point in the future (see my back problems listed in my bio), I just hope it's much later! LOL

    I don't know if I said something that led you to believe that I was progressing in my efforts towards remission of fibro, if I did, I must have been really foggy that night, but my fibro is just about always flared up do to everything else that I have and what I have to do to keep going every day, but I do certainly hope that you and others here on the board could achieve some progress into feeling better and ridding their body of fibro.

    If you have time some time, complete your bio so we all can learn a little bit more about you!

    Thanks for taking the time to read some of the articles that I have posted, as well as taking time to respond. You never know if anybody reads this stuff or not!!!! LOL

    Big Hugs,
    Janet