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Andrea asked...

Unsuccessful spinal nerve root injection.

I am writing on behalf of my mother who until 8 months ago was an active young 75year old. She had a recurring bout of sciatica which did not respond to physio and required codeine and amytriptyline to keep on top of the pain.

6 months ago she had a spinal nerve root injection which was unsuccessful. She is still experiencing back and leg, specifically knee, pain despite resuming pain relief meication.

Her activity levels are severely restricted and her mood is low. She has been told that a second injection is not possible until 6 months has passed. Is this correct? Is it likely to work if it didn't work the first time? If she wants to seek a second opinion are you able to provide a list of consultants? Many thanks for your time.

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The answer

The frequency with which a spinal nerve root block is performed can vary according to the actual drugs injected and the overall health and symptoms of the person receiving the treatment.

Typically, the injection will consist of a local anaesthetic to reduce pain in the nerve root, or a steroid; often patients will receive a combination of both. As your mother derived no relief from her initial injection it might be useful to ascertain whether she received a steroid or a locally acting root anaesthetic or a combination of both. Possibly, if she only received the steroid for example, it might be worth exploring with her specialist whether anything else could be given in combination to help.

In terms of pain, if she has an ongoing back issue this can have an effect on the way weight and posture is being distributed throughout her legs; this in turn could lead to chronic strain on her hip and knee joints. You do mention she specifically has knee pain and her knee joint may have undergone some changes. X-rays and also bone density scanning can aid diagnosis with this and there are various treatment options to help her with her knee if changes are found to have taken place.

Restricted mobility and chronic pain can certainly have a significant effect on a persons’ mood and I’m sorry your mother is experiencing this in addition. If she would like a second opinion from an orthopaedic consultant regarding both her back condition and the problems in her knee with a view to investigations and forward treatment planning, we are able to give you the details of PPP approved consultants in her area of course.

You can also call us here at AXA-PPP Health@Hand at any time to discuss your concerns in more detail; we are available 24 hours a day on 0800 003 004.

Answered by Health at Hand nurses.


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