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Dr. Abaci, Would some typt of shot in the neck help for Osteoarthritis with bone spurs?
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hisfaithful1 posted:
I did have a cortisone shot in my left hip about a year ago but it did not help. The neck pain I have is constant every day, and is worse at night. Would some kind of shot help?

Thank You
Debbie
Reply
 
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Peter Abaci, MD responded:
There are a few different types of injections to be considered for neck pain. For more muscular pain and tightness around the neck, trigger point injections may be an option. This involves injecting local anesthetic into tight muscle knots to help relieve tension. This can be done in the doctor's office, and this type of neck pain is commonly seen, partly due to our use of computers and other similar devices. Botox would be a longer acting medication to inject into the muscles, but it is often not covered by insurances when used for pain.

Another option would be a cervical epidural steroid injection. This is typically done when there is nerve root irritation around the neck causing radiating symptoms down an arm. A less common injection would be around the facet joints, which are the little joints between the vertebra in the neck. This can be considered if there is an arthritis problem there or after a whiplash injury.

Remember that regardless of the injection, they don't typically last forever, and they should probably be used as part of plan that may include postural education, exercise, stretches and other treatments as appropriate.
 
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hisfaithful1 replied to Peter Abaci, MD's response:
Thank you for your kind reply.

I'm just trying to figure out what my best treatment plan might be. I am not on the computer too long at one time, and I had physical therapy for my neck about one year ago. I have also become educated about the importance of exercise and stretching. No matter what I try the pain stubbornly persists! Also it does travel down my right arm.

The pain medication I take does give some relief, perhaps around 50 %. But when it wears off the pain is always back.
Should I have an MRI done? So far I only had an x-ray which showed the osteophytes and arthritis.

Thanks again Dr. Abaci. I appreciate that you are nice enough to help us all out here on WebMD with your knoweledge and expertise.

Sincerely, Debbie
 
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Peter Abaci, MD replied to hisfaithful1's response:
Hi Debbie,

I think if you are having pain radiating down your right arm, then an MRI would be a reasonable test to have done, especially since the problem has persisted. Some of the procedures we discussed above may help with this, and other treatments could be considered by your doctors like acupuncture or traction, as examples. Good luck!
 
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Painder replied to Peter Abaci, MD's response:
Partly agree, injection do help but in diagnosing and working out the type and location of pain or is it referred pain or projected pain. What is more important is accurate injection under x-ray guidance can locate pain sources . Usually these sources can be seen or diagnosed with MRI, X-ray, etc. The expertise of locating and proving the pain sources depends on the expertise and how good your pain doctor really is.

Medications do not help as it treat symptoms.
 
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hisfaithful1 replied to Peter Abaci, MD's response:
Thank you Dr Abaci,

I asked my pain management doctor if he thought an MRI was a good idea and he readily agreed. Hopefully I can find more out about what the root problem really is now, and find a better solution to this problem.
 
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hisfaithful1 replied to Painder's response:
Thanks for your input Painder,

I know medications are only treating the symptoms, but I would be in agony several hours a day without them. It was a hugh relief to have my pain level cut down some even if it is only a temporary solution.

Take care, Debbie
 
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buschia replied to Peter Abaci, MD's response:
I have had 2 ESIs with little to no relief. Last week, a medial block at C3-4 .4-5. 5-6.6-7 was tried. also minimal relief for 24-36 hours. Any hope or must I submit to surgery for relief? 24/7 pain in the 8 - 9 area is intolerable.
 
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Peter Abaci, MD replied to buschia's response:
Buschia,

I would not be able to say whether or not neck surgery is a good option for your particular problem. One bit of advice though is don't feel like you need to have surgery just because you have tried other options and your neck still hurts. Spine surgery is a big step and it isn't necessarily always the best way to treat a chronic pain problem that hasn't improved.

Try to be really clear with your doctors as to what they expect to see accomplished by the surgery so that your expectations are aligned. Also, don't forget to talk about what the long-term implications look like for you with and without surgery. For example, does your surgeon anticipate you needing another surgery on your neck down the road if you have the first one?


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