Occipital Neuralgia and other Cranial Neuralgias For discussion of Occipital Neuralgia, Glossopharyngeal Neuralgia, Nervus Intermedius (or Geniculate Neuralgia), and Vegal and Superior Laryngeal Neuralgia. (Trigeminal Neuralgia has its forum below.)

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Old 08-25-2008, 01:05 PM #1
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Default Nerve blocs without fluoro

Hi, I'm scheduled to have bilateral nerve blocks tomorrow without the aid of fluoroscopy(sp?). My BF who is an x-ray teach says they tend to go better with the fluoro. Does it make a difference? Any word of advice for the blocks tomorrow? Thanks...

Diana
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Old 08-25-2008, 03:48 PM #2
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I don't have any advice for you since I'm finally scheduled to get mine on wednesday. I just wanted to wish you the best and hope that you'll get relief from them.
Take care, Ellena
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Old 08-25-2008, 11:26 PM #3
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Thanks Ellena, I'll let you know how it goes.

Take care,Diana
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Old 08-26-2008, 06:27 AM #4
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Diana,

I hope you can read this in time. But NEVER, EVER let any doc do nerve blocks in the cervical spine without Fluoroscopy! Sorry, I don't mean to be abrupt but I just saw your post and I am ASSUMING you are speaking of having them done in the cervical spine. Yes, it DOES make a difference...you do NOT want them going bllindly in at all. How could they possibly see which nerve (area) without it? IF, however, you are speaking of trigger point injections, then, no, you don't need Fluoro. I have had those done in my scalp and the docs palpate the area to find the nerve and inject CLOSE by it. But as for the spine...whole different ballgame.

Anyway, I have had these done dozens of times over 8 years both cervical and lumbar and NEVER once did my PM NOT use Fluoro. So, be careful! If I were you I would either insist on it, reschedule if possible OR find a doc that does use Fluoro.

Please be careful and let us know how it goes.
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Old 08-26-2008, 10:29 PM #5
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Well, I've never heard of a 'Fluoroscopy'? So, I can't really answer your questions. I get occipital nerve blocks, (left side) and they are over pretty quickly with no sedation or anything like that, when my neuro does them. He just 'feels' for the nerves, and it hurts like mad when he presses on them, but his injections have been really helpful, and there's been no problems afterwards.
So, what is this 'Fluoroscopy' like, what do they do? I guess it's not used for the occ. nerves then? I've never heard of it...

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Old 09-01-2008, 06:34 AM #6
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Hi Jaime,

Flouroscopy is an xray machine so to speak. When they are giving injections into the spine; facets, selective nerve root injections, ESI's, the docs SHOULD ALWAYS use the xray. Otherwise they can't see by blindly going in. But for trigger point injections BY the nerves or as in my case, in the scalp, no you don't need it. I think it all depends on what injections a person is speaking of. For instance I see ESI alot whent he person means another type of injection. Anyway, when dealing with the SPINAL injections there is no way a doc should be going in without the use of Flouroscopy guidance. If a doc says he can do the SPINAL injections without using xray, RUN...don't walk! But again, if it is a blocking of the nerves in the scalp and that sort of thing that's different. And you are right; the doc palpates the area, finds the nerve and then blocks it. I have had plenty of those done too. But eventually it was determined it was all coming from the spine and THAT is when Flouroscopy was used. It is just basically a LIVE guided xray as they perform the injection and is usually a C-arm that goes over the area to be injected; they take pics too as they go along and guide the needle placement.
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Old 09-01-2008, 01:07 PM #7
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Just an update. I did get the steroid nerve blocks without any imaging. The pain doc felt next to the suboccipital muscles where the symptoms were reproduced a couple weeks ago. Unfortunately I felt no relief from this, and it's been 6 days. I did receive some trigger point injections also(seems my whole upper back is one big trigger point) and those seemed to relax that area a bit.

So now I'm not sure if the steroid block didn't work, or if it was in the wrong spot. Not sure what the plan is next.

Take care, Diana
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Old 09-02-2008, 06:32 AM #8
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Diana,

I am sorry to hear that the blocks didn't or haven't worked yet. You could give it another week since sometimes the steroids won't kick in for a week or two. Glad to hear that the trigger points are helping though.

Also, ask or have the doctor order an MRI of your cervical spine if you haven't had that done already. It is possible that something is going on in your spine referring pain upwards.
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Old 09-02-2008, 03:19 PM #9
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Hi, i'm still hoping the injection will do something. I guess I should have asked the pain doc this, but I'm wondering how the steroids would block the nerves. I know steroids are an anti-inflammatory. Does it just decrease the inflammation of the nerves? And also not sure why it would take so long for them to work.

Take care , Diana
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Old 07-27-2009, 02:51 PM #10
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Are your nerve blocks of anesthic & steroid ? i have just had my 14th nerve block, i always feel very unwell for following wk but then as the block kicks in
i improve but can be 2-3 wks before i get some release from the pain.
so you should give it time.
my occipital neuralgia is all the lft side of head & face.
jane
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