My poor mom has been suffering from chronic lower back pain (center low back) for awhile and a recent pain in her upper right arm muscle (?) below her shoulder. Her family dr hasn't been helpful and so I'm taking her to a Pain & Spine Center on Monday referred to me. Looking at their website, it seems highly likely they will probably give her some sort of an injection. Perhaps trigger point injections, cortisone/steroid shots etc but I am very worried that they may do more damage than good, be very painful and not help her in the long run. Has anyone had any personal experience in this arena? Her pain is not from any injury.. not a sharp pain but very achey constantly and more painful with certain movements. x-ray nor dexascan didn't show anything remarkable. I love my mom more than life itself and am just constantly stressed over this!

By Pamt on Friday, October 7, 2005 - 03:07 pm:

She needs to get into physical therapy ASAP. It will do wonders for her. I have occasional acute back pain and I am always fixed in 1-2 sessions. She will need a prescription from her MD for PT.

By Tklinreston on Friday, October 7, 2005 - 04:35 pm:

Pam, did you ever find out what was causing your acute back pain?

By Ginny~moderator on Friday, October 7, 2005 - 05:01 pm:

Joyce, as a chronic back pain person with a ruptured disk, no one should do any injections or treatments until your mom is seen by an orthopedic specialist who has the necessary diagnostic tests done (x-rays or MRI) to give a diagnosis. X-rays will often not show disk problems, but an MRI will. If it is a nerve problem, then a myleogram may be called for. (This is painful, I can tell you from experience, but it is one way of diagnosing nerve injury.)

I'll post more over the weekend, or you can email me at klipvm (at) rcn.com. I am probably closer to your mom's age, being 66. I have had low back pain, lots of discomfort/pain in my left shoulder, arm and hand that turned out to be the beginnings of cervical (neck part of the spine) arthritis, referred pain in my hip from a disk pressing on nerves, pain in my hip that is bursitis, and just general coming to the end of my parts warranty arthritis in neck, back and knees. And my mom lived with me for five years before she died at 82, and had lots of arthritis and spine related pains. Those experiences may be helpful to you.

I am really not comfortable with a doctor doing injections or anything else without a definitive diagnosis, and a definitive diagnosis shouldn't be that hard to get. And, my own orthopedic doc told me a couple of weeks ago that he very seldom does cortizone injections for bursitis (my present ache), because it seldom does much good, certainly no long-term good, and can be very painful to the person. These docs may be very good, but my rule of thumb, except for immediately life-threatening emergencies, is diagnosis first, treatment to follow. And for back and nerve pain (the shoulder sounds like it could be referred pain), an MRI is a fairly common diagnostic tool.

By Pamt on Friday, October 7, 2005 - 05:12 pm:

Joyce, a couple of times my sacroiliac joint was knocked out of whack. This happens pretty commonly in women and it was very hard for me to stand up straight. I had to walk sort of hunched over. Usually one leg will appear slightly shorter when laying down or one hip will seem a little higher when bending over. The PT was able to adjust things back into position and show me exercises to strengthen the area to keep it from happening again. I also had ultrasound and that felt soooo good. The other time I thought it was my SI joint (felt similar) but apparently I was just having some muscle spasms. Once those were worked out I was pain free.

By Tklinreston on Friday, October 7, 2005 - 05:14 pm:

Wow Ginny, you have been through so much! My heart goes out to you. How are you these days besides your bursitis? Yes, you are close to my mom's age. She will be 64 in January and definitely does suffer some arthritic pain but it's been her lower backand right arm, which has been bothering her alot. I will definitely email you over the weekend. That is what we need right now - a definitive diagnoses and I hope and pray that this doctor can finally help her. I am definitely not looking for quick fixes for her but need to find a treatment that will help cure her as much as possible and improve her quality of life. I'll be in touch with you. Thank you so so much!

By Tklinreston on Friday, October 7, 2005 - 05:18 pm:

Pam, that sounds painful. I'm glad you are doing better. The center we are going to is staffed by medical doctors and has a PT center on site. I am keeping my fingers crossed. It's so hard to find good doctors. If they tell her she needs injections PRIOR to getting an MRI I will be highly suspicious of them. I'm taking with us x-rays which was taken recently which doesn't show the underlaying cause of her pain so as Ginny suggests, she will probably need an MRI.

By Hlgmom on Friday, October 7, 2005 - 08:25 pm:

Has she ever considered a chiropracter- I have had lower back problems for about 10 years and ignored them etc...finally went to a chiropractor about a month ago and it is soooooo much better! Just a thought since I don't know exactly what is wrong! Hope it gets better!

By Marcia on Friday, October 7, 2005 - 08:56 pm:

I swear by my chiropractor, too. I especially love that she's not afraid to tell me if it's something she shouldn't be treating, and refers me to the doctor. Most of the time she's an incredible help, and the results are quick.

By Feona on Saturday, October 8, 2005 - 07:26 am:

I got rolfed. I had any kind of pain you can think of. Back pain - sciatica - right shoulder pain - right hand pain. heel pain... Moved around..the pain.

Got rolfed and I am all completely better. I mean I was in serious pain for 10 years. Skip work and can't sit in a movie theather pain.

By Karen~moderator on Saturday, October 8, 2005 - 08:42 am:

As a veteran of 2 back surgeries, I agree with Ginny about testing. Xrays will NOT identify soft tissue injuries, such as injured muscles, or ruptuered or herniated disks. An MRI is needed for that.

Before my 1st ruptured disk, I used a chiropractor for my back and my neck. The chiropractor is the first one to diagnose the degenerative disk disease in my cervical spine. A GOOD chiropractor will not touch you or perform any adjustments at all until tests are done though.

As for injections, Ginny's right, they are OFTEN a temporary fix. I've had cortisone/anesthetic injections in my neck, back, hips and elbows, my back and elbows have been injected a number of times. Sometimes it helps, sometimes it doesn't. There are a number of different opinions regarding cortisone injections, and for the *right* reason, they can be helpful.

However, if the pain is from a ruptured or herniated disk, or pinched nerve, the only thing the cortisone will help with is the inflammation. It will NOT solve the problem. Lower back/disk problems from L4/L5/S1 will affect your legs, feet and bladder/bower control. Problems in your neck can affect your arms and hands.

In some cases, regular stretches can help a lot, because sometimes the pain is referred from tight/constricted muscles, or the myofacsia.

IMO, your mom should INSIST on a cervical MRI and an MRI of her back. I absolutely would not get any injections until I knew exactly what I was dealing with.

*IF* she does have a herniated disk, that does not automatically mean she needs surgery either! Encourage her to get testing done, and let us know what the results are.

By Tklinreston on Monday, October 10, 2005 - 02:40 pm:

My mom saw the doctor this morning. The shoulder/arm pain in her left arm (I had mistakenly wrote "right" arm earlier) he said was most likely tendonitis. She has severe limited motion in that arm... can't lift it up high nor reach towards the back. It will be x-rayed tomorrow to confirm tendonitis and to rule out problems with the bone, but in the meantime, he suggests cortizone injections (2) to reduce the inflammation and to get PT underway asap. According the the dr, without the reducing the inflammation she won't be able to do PT, which ultimately is what will heal her. As for her lower back, she definitely doesn't have any bone problems and he didn't think she had any disc problems either based on her x-rays, although some of you had mentioned you can't diagnose disc problems from an x-ray. Unfortunately, due to accupuncture treatment she had done nearly 30 years ago where a bunch of tiny needles are broken up and left in her body, dr says she is not a candidate for an MRI, but he also said he didn't feel that she needed an MRI anyway. Since her pain is tolerable and we don't have a definite diagnosis w/o an MRI, we told the dr we are not interested in any injections into her lower back. He agreed and recommended that she start PT right away. And so, I am still very much in the gray as to her back but feel that we are close to a diagnosis for her arm.

By Marg on Tuesday, October 11, 2005 - 07:16 am:

I'm so sorry to hear all that is going on.

I'll be thinking about you both today.

I have a huge problem with my hands, and I went to a hand specialist who said the shots just help for a short period but do not help correct the situation.

By Karen~moderator on Tuesday, October 11, 2005 - 09:46 am:

OUCH to the acupuncture needles!!!!! I can see why an MRI isn't a good choice with all that metal in her body. Cortisone injections will work well on inflammation and P.T. will definitely help her.

Just a suggestion here - and it's not for everyone - there is a treatment for tendonitis called Prolotherapy Prolotherapy, - it's a series of injections directly into the affected joint. I went through this a couple of years ago. It's very painful to go through, but you can request an Rx for a cream called Emla that you apply to the area to be injected an hour or two prior to the injections, it numbs the skin, though not the deep tissue that is injected, and most doctors will give you an Rx for pain meds for after. It is numerous injections during each treatment in the area that is affected, and the first couple days following treatment, are very painful. When I had my elbows done, it was like 24 injections in each one in a circular-type area. It causes more inflammation initially, and you use heat on it for a couple of days, the inflammatory response triggers a healing response in your body. But long term, it helped me. I had tendonitis so bad in my elbows I literally could not bend them without actually helping with the other hand. Just a suggestion - if your mom can stand the initial pain of the treatment and there's a doctor who performs this treatment, it may be something to consider. You have to have multiple treatments usually monthly, normally if you aren't noticing results after the 4th month, and certainly by 6 months, it's not working for you.

I hope she starts improving!

By Tklinreston on Tuesday, October 11, 2005 - 09:50 am:

Thanks Marg. I am so sorry that your hands are hurting. Did the specialist offer any alternative solutions to your problem? My mom is opting to return today and get the two cortizone injections in her shoulder to reduce the inflammation and start PT on Monday. I still feel very certain about everything but the dr is saying regardless of the diagnoses .... tendonities... bursitis of something else perhaps, it is clearly inflamed and painful. She can't move her arms around w/o pain and so she needs the shots no matter what if she is to start PT. My moms feels why put off the inevitable if it will give her some relief sooner. I just don't know...

By Tklinreston on Tuesday, October 11, 2005 - 12:17 pm:

Wow, Karen. The prolotherapy sounds painful! You are a BRAVE woman. This practice does have this therapy and judging from their website they are big advocates of it. My mom is sooo afraid of needles but if nothing else helps and this helped you, it is definitely something to consider. How long ago did you have it done and is your tendonitis in the elbow gone now? By the way, I just have to say how AMAZED I am time and time again at the wealth of experiences and knowledge all of you moms have on this site!! I am truly grateful for all of you. Thank you! Thank you! Thank yoU!

By Marg on Tuesday, October 11, 2005 - 12:27 pm:

Many prayers for you and your mom.

Wow, so soon to start the therapy!

Whatever I have has caused bone on bone rubbing in my hand. The radiologist misdiagnosed and two doctors at the doctors office. They did not recognize the severity of my problem.

The specialist stated shots would give temporary relief. I wear a brace and take glucosamine pills. After 3 months the specialist will decide. It will have to be a miracle otherwise I'm looking at an operation.

Good luck to your mom, keep us updated.

By Karen~moderator on Tuesday, October 11, 2005 - 02:07 pm:

Joyce, it's been a couple of years. At the time I had it done, I had tendonitis in both elbows. It was incredibly painful and was truly affecting normal motion and activities. I went through 6 months of it. I had really good results with one elbow and not-so-good results with the other - at the time. The trick to prolotherapy is, when you are undergoing the treatments, you are *supposed* to stop doing whatever repetitive motion that is causing the injury. In my case, it's my job, so I couldn't stop - the 8 hours a day of calculator to pen to keyboard to calculator... you get the gist.

But I noticed a couple of months after I stopped the treatments that my elbow pain was almost 100% gone, and then it WAS 100% gone. It's only been in the last couple of months that I feel a twinge every now and then.

My doctor who administered the injections has had prolotherapy himself for *tennis elbow*. I've met several other patients of his in the waiting room who were having it on their neck, back, other body parts.

It IS *very* painful though, it's numerous injections with the irritant all around the affected area, and there is a lot of swelling for a few days. But the swelling is what triggers the healing response, and it must be true, because it worked.