To ask if anyone knows what the process is

[Anononony]

For getting either nerve block injections or cortisol epidural injections for back pain? Has anyone been successful in accessing this as an option?

Long story short, OH has ongoing, often crippling back pain and sciatica from an old injury. It has forced him out of work (forcing himself though the pain was destroying his mental health) but even with not working there's no real improvement in symptoms, it's not as bad day to day as it was when he was working but there's still constant pain and flare ups which leave him really struggling. Not disabled enough for disability benefits from what we can tell (he could do all the things they list, it will hurt him but not incapable)

I think one of the above injections could be worth a shot, but it's not something that has ever been offered by the GP. He's going to go back next week and ask specifically for this, is it something the GP can refer directly on for or does it have to be via a referral to the pain clinic? Having spent some time on Google the pain clinics seem rather convoluted, it sounds like lots of talking/group therapy on how to live with your pain, he's very good at living with pain having done it for 15 odd years, that's not what he needs, he needs help to actually get rid of it so he's able to work

So as to avoid a drip feed - had MRI about 3 years ago which showed old healed injuries but nothing that should have been causing so much pain, nothing fixable with surgery. Is prescribed tramadol but the dose often isn't enough so he takes an extra but then of course they don't last long enough, GP won't prescribe more and have insinuated in the past he's just a junkie looking for meds

Has anyone been in a similar situation and managed to get it resolved and be somewhat pain free?

If its a spinal injection they only do those in hospital clinic. Ask your GP for a referral x good luck 🍀

I think it entirely depends on your GP and referral protocol and what your NHS Trust’s policy is. Our GP wouldn’t refer DH for cortisol epidural when he had sciatica earlier this year as apparently there’s increasing evidence that the efficacy isn’t particularly good and better results can be obtained through physio, and the Trust will only fund it for sciatica with other complications.

DH opted to go private for an epidural as we have private insurance and whilst it’s anecdotal, it was indeed pretty ineffective. Friends who’d had similar problems recommended their physio: ten sessions later and keeping up with a daily routine of stretching the physio prescribed and he was back to full mobility and no pain.

Hmm, he's done physio on and off for years, but is always very hesitant as they seem to pull him about and leave him in huge amounts of pain afterwards and there never seems to be an improvement, he went to one my mum recommended (she's an OT so had worked alongside this physio) and he could barely move for almost a week after seeing him, so he's understandably very wary!

I had several spinal injections before I gave up but I have an injury caused by spinal surgery so may be different. His GP will need to make a referral but may well need to go via a pain clinic and waiting times will almost certainly be lengthy.

Injections can help with leg pain but aren’t very helpful for back pain. He would almost definitely benefit from a pain clinic referral because they can access various services and will advise on pain killers. Tramadol is a strong opioid but he might benefit from adding in other types of meds such as anti inflammatory drugs and something like pregablin and or amitriptyline for nerve pain.

There are also spinal cord stimulators which are a bit like an internal TENs machine which some people swear by but again are via a pain clinic.

I really sympathise because living with chronic pain is so draining. I treat it a bit like a jigsaw- there is no one cure but lots of small things put together do really help. Drugs, heat pads, the right exercises, distraction, rest and so on.

Yes I have cortisol 💉 injections,
what a difference they made in my case,

i really think i would have ended in a wheelchair ♿️ if i hadn't taken up this option,

It doesn't work for everyone, but what a difference it makes when it does,

I have Rumertoid and OestoAthritis so I had an injection in my knee for Oestro Athritis,

as my knee cap cartilage joint had worn down so much i was in excruciating pain could hardly walk ,

with combo of Rumertoid athritis drug mediation included its made such a difference to my life

You really need to push often for your Doctor to refer you to a spealist consultant, to have this option done,

Also get in contact with NHS PALS uk website and look up whatever hospital area you come under

they act as a go -between hospital and patients in regards of welfare ,
such as any issues such as regards of accessing /pushing your case for treatments ..

they have helped me a couple of times , such as when someone last min cancelled their hospital appointment last min,
i was asked if i wanted a second cortisol injection 💉 appointment on that day in place of the cancelled appointment,

instead of having to wait a few/several months later time for my spealist doctor consultation appointment.

I’ve had 2 spinal injections for a herniated L4 L5 disc. The pain is worse than childbirth and a gallbladder attack COMBINED.

I ended up in A&E to get morphine because I was passing out with the pain.

I had one injection using a CT scanner and the pin went away for about a week. I went back for another and a year later I am still pain free. I do get pins and needles in that foot so I am always wary about heavy lifting etc.

I am not in the UK so I don’t know about referrals but do get him to fight for it. The pain is indescribable.

I have foot pain following an accident.

I had one of these and it did make a temporary difference and allowed me to access physio - much like your husband my pain was too bad before.

I can also suggest -

Hydrotherapy is better than physio as it's less painful generally; GP would be able to refer.

Pain clinic referral will get him seen by an admitting clinician - mine got me NHS hydro and was able to recommend specialist physio plus reviewed my drugs for the better - they don't just send you on courses to live with your pain

Also, usual recommendation for chronic pain that has lasted that long is to consider drugs to reduce nerve pain - amytriptyline is the first one but there is also duloxetine and others. I found they made a bit difference and I now take fewer painkillers as the duloxetine mostly keeps the pain under control.

DH has two rounds of steroid injections into facet joints for pain caused by collapsing discs. He was referred after numerous visits to spinal unit and two lots of surgery. He described the injections as "like magic" as if the pain was just switched off instantly, but as others have said, it only lasted for two weeks each time. He was referred later to have the nerves in the spinal joints cauterised but unfortunately this didn't work at all and if anything is now worse, and because the steroids only lasted such a short time they won't refer him for more on the NHS. He's stuck on high dose anti inflammatories and pain killers, which look to be permanent.

I've had steroid/anaesthetic injections and trigger point injections in my spine. Didn't do a thing. I'm waiting for a nerve block next but a friend has had a couple and she said they did nothing for her. Sorry.

Hmm seems very hit and miss so I guess I can see why it's not something they rush to do, what a shame I was hoping it would be an easy solution!

He has tried amitriptyline in the past but that was alongside lower level painkillers like cocodamol, not the tramadol, he was taken off it before given the tramadol but maybe we could ask for something nerve specific alongside the tramadol

He's not awful day to day with the tramadol, he can do things like collecting the kids from school with lower level pain, but it's very easy to cause it to flare up massively, he tripped up a step a few days ago and can still barely move now. And he doesn't feel he could hold onto a proper job as it's so unreliable, and from previous experience its not worth the damage to his mental health that was awful when he was trying to push through and work, at that time our eldest was a baby and he could barely pick him up (and didn't trust himself to carry him about for fear of his back spasming and the risk of dropping him)

For pain relating to sciatica seriously consider looking for a practitioner who can offer myofascial release. There's someone local to us doing it who virtually has people queuing out of the door from reccomendations from people they have previously 'fixed'. I've not used them personally but a friend with very similar sounding pain to your husband's has been a new woman after a few sessions.

Also - when looking at the benefits forms you have to answer based on what he is able to do on the very worst days if trying to live normally (i.e. working) - it's the worst days cureently that prevent him from from working after all, not the days where he's been able to take it easy and only do what he is capable of doing that day.

Sounds awful. I have nothing to add on the medical side, but could your husband claim PIP? There are two parts, mobility and day to day. He may not get the mobility side of it, but if he struggles to do basic day to day living stuff, he might qualify for that. You can do it on line now, it's worth applying even if you get turned down.

@AnonononyNot disabled enough for disability benefits from what we can tell (he could do all the things they list, it will hurt him but not incapable)

For PIP, if the answer is "yes I could but it will leave me in such a state of pain and debilitation that it seriously affects my capacity so I avoid it as much as possible because it hurts so damn much and if I have to do it then I need a lie down afterwards to recover" then your real answer is "No" and it is ok to say so. "Yes" in the context of a PIP application means you could do it repeatedly without it being an enormous effort or causing you pain or distress.

Exercise, stretches, low inflammatory diet and tens machine.

Thanks all, so our plan now is to go to the GP next week and see about adding an anti-inflammatory and a nerve medication and seeing if all 3 can get him to a point where he feels able to risk a physio appointment, which is self referral here so we can do that as soon as the pain is under control. If we can get a go at the injection he'll take it to see if it works

He's not overly active currently, he walks but nothing more strenuous than that, but if the pain is better controlled he'd be able to follow physio exercises and strengthening exercises

The myofascial release could be an option if it's something offered on the NHS, we've had some success in the past with a chiropractor but it needed to be regular and we couldn't afford to keep it up

I'll look further into pip, thankyou for the advice on this, Ive always heard that if you don't basically crawl into the assessment you won't get anywhere so it's good to hear otherwise