Lidocaine Infusions
 

Hello all,

I recently had a discussion with an anesthesiologist regarding my PN pain. (I am not a diabetic nor has any other reason been found for my PN so I have been an Idiopathic sufferer for about 4 yrs.)

He asked if I had ever heard of lidocaine infusions for the treatment of PN pain. I had not and so I thought I would bring it here. Has anyone been treated with lidocaine infusions for PN?

Thanks,
Nancy-H

Nancy - that all is interesting....
 

Just did a search on it and the only thing that gives me 'cause for pause' is that there really isn't anything very 'current' on it as a therapy. Most of the research seems to be in small focus specific groups.

WHY hasn't it caught on? would be my big question.... I also feel that it's interesting that your pain doc would stretch and be, essentially, experimental. It's an aspect that can be good or bad.

It it were me? I'd really read the fine print about s/e's of lido infusions in all findable instances and maybe give it a try. I hesitate because when I use patches things go VERY dead and there are times the trade-off is worth it and others when it's not.

Whatever your decision, I for one, am awaiting for what all happens! - j

The same thoughts. . .
 

went through my mind. This is not something he was suggesting that I try at this point in the game but something that he had discussed with a doc at a pain convention. Waaaaay more info needs to come to me before I connect to a drip :-)

There is one machine that they have at the hospital here, which is new and so all the equipment is new. But, dummy me misplaced the brochure so I don't have the correct name to share. It's like a big TENS unit. Anyone heard of such a machine?

My pain has increased something terrible lately and I've not done anything to bring it on. It starts at bedtime and goes until about 3 a.m. or all day the following day. I know you guys are no strangers to pain but this has been going on now 3 weeks. How long do your pain flares last???

My best to all,
Nancy-H

I just googled Lidocaine Infusions!!!
 

Here's some of what the information says:

"Lidocaine Infusion
Intravenous lidocaine infusion is occasionally administered for diagnostic purposes. A "lidocaine test" may be given in patients with suspected neuropathic pain to predict response to oral mexiletine.[24] If the pain is neuropathic, transient pain relief may occur, lasting for several hours.[24] One study of a small number of patients reported pain relief lasting days to weeks after a lidocaine infusion.[24] Electrocardiogram and blood pressure monitoring are required during continuous infusion of lidocaine, and resusci-tative equipment must be readily accessible.[24]
Contraindications to therapy are hyper-sensitivity to amide-type local anesthetics, Adams-Strokes syndrome, and high-grade heart block.[24] Adverse effects are dosage related and transient. They include paresthesias of the fingers, abnormal taste, tinnitus, blurred vision, drowsiness, and dysarthria.[24] Higher dosages of lidocaine may cause cardiac arrhythmias and seizures. If the patient experiences drowsiness or dysarthria, the infusion should be discontinued immediately.[24] To administer lidocaine intravenously, a dose of 5 mg/kg of body weight should be infused over 30-45 minutes.[24, 41]

Continuous subcutaneous lidocaine infusion may be useful for the management of neuro-pathic pain states. Such use should be under the direction of a pain management specialist."

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Now, I can't tell you how many times I have asked neuros, pain management docs, everybody who wears a white coat, I have asked the following:

"Why can't they just take an injection of Lidocaine and stick it where it hurts (like with Alan, it's between certain toes of each foot, and it drives HIM CRAZY, SOMETIMES") Well, you should see the look the docs give me, a look like "what is she nuts, or something??"

And now I hear about something called a lidocaine infusion. You know, I wonder if they can mix it in with his IVIG, I mean, once they start doing it???

Interesting stuff.

Mel

Lidocaine Infusions...
 

I have not had regular Lidocaine infusions, but I did have Lidocaine in my IV, when my gallbladder was removed. It was WONDERFUL... I saw a pain management doctor not long after that who was going to try me on this, probably as Melody said, to see if I was a candidate for Mexiletine.

My Neurologist said "ABSOLUTELY NOT." I cannot recall why he was so definite about this..

I do get trigger point injections with Lidocaine and a little Cortisone, which helps in the places that hurt. It is not permanent, but in my case has been a Godsend at times. It varies on how long it lasts. I was leary at first about having this, because an old doc injected my back with this once, and it hurt like the devil-probably because the needle was huge. This doc uses a very fine needle and deadens as he begins. You hardly know you are being stuck... He also does the epidural, which helped considerably with the lower back.

Cathie

TRIGGER SPOT INJECTIONS!!! That's what I was referring to!!!
 

Every time I asked a doctor, I was told "No, it's not possible"!!!

And now I hear that you have gotten them!!!

What is wrong with these docs???

Melody

Here you go Melody
 

Trigger point injections... Right there in your neck of the woods...

http://www.freeofpain.org/html/painm...retrigger.html

Cathie

P.S. I am not saying whoever this is is good. I am just saying they do these in Brooklyn... :)

Now aren't you a doll!!1
 

I just told Alan, he ran over to the computer, he took one look at Trigger Point Injections, and said "where do I sign up?" I said 'take it easy'.

We'll give them a call and ask our questions. Now, a long time ago, Alan used to go to pain management doctors for his PN, they had him on Ultram, vicodin, and finally, the Fentanyl Patch. This was around 2001 and 2002. Then he went to get the epidural thing. He did nothing!!!

And why no one ever suggested a trigger point thing is beyond me. You see, I have no idea if this will work on Alan. And if you think about it, he's had 5 rounds of IVIG and soon will (hopefully) begin the home infusions.

Now if he gets a trigger point, and he feels no pain (AND THIS IS NOT A BAD THING, BELIEVE ME), how can he tell if the IVIG thing is working??

He's going to call us this trigger point guy anyway and ask his questions.

Wow, if there's a way to stop the pain between his toes (besides using Blue Stuff and me pounding on his back), that would really be something. He wants to get a part time job so we can at least have a life. Right now, all we do is go to doctors and pay co-pays. I know there are many many people who have a much much worse case of PN than Alan. I do realize this. But for 18 years this guy has been shaking his feet, not able to lie down or sit down for any length of time without resorting to xanax, and other stuff, well it would be a nice change of pace to live normally.

I really don't see this happening any time soon. I guess I'm defeated or something. I have to be happy that we have a roof over our head.

A lot of people don't even have that. I know this.


Will let you know what Alan does with this Trigger Point thing.

Regards and much thanks for the info. You are a special doll!!!

Melody

Melody;

I had trigger point injections and they worked for about 6 months each. This went on until I moved here and my new doc did them as well. But soon the six months started inching back to 4 months, then 3 then 2 and at that point they started to hurt, rather than help me. But, I had success with them for 3 years. So, I'd talk to your doc about them.

As far as asking questions to doctors - I do it all the time for myself and my wonderful husband who has back, neck and orthopaedic issues. I have to ask the questions and sometimes it leads to possibilities!

Good Luck to All,
Nancy-H

Trigger Point Lidocaine
 

I get relief whenever I get them, but I do not get them on a regular basis, only if I just have to have them. They have a little cortisone (cortisol?) in them, and I don't like taking more steriods than I already take. I have been told the injections contain a small amount though.

Along with Prednisone, I try to make do with various combinations of different things I have tried (some prescription, some over-the-counter.) My friend gets injections far more frequently than I do and I don't think she could tolerate her pain level without these.

Injections between the toes sound like a painful area to have stuck, even with deadening though. The feet are very sensitive. I have no idea how that would feel. I had one in the bottom of my foot once for inflammation of the fascia. It was done by a Podiatrist and it was pretty painful, because of the inflammation present. It was very effective though.

Mel, you might want to google up, Trigger Point Injections Brooklyn and call and see if anyone has ever done feet, or the area between toes before.

Cathie

Forgot to ask...
 

Do you all have a pain management doc? Some of these people, along with anesthesiologists can be pretty creative when it comes to pain.

Cathie

I've had Trigger Pt. Injections for 23 yrs. Great help
 

Please know if you can get the right Dr. TPI can be a wonderful relief. In 1984 I suffered from facial pain, TMJ pain and terrible headaches daily. I barely could make it to work. Luckily, I did not take the advice of local dentists and have TMJ surgery. I spent 400 hrs. in the library researching and then flew around the country to see the top dentists in the field treating this condition. I chose one who was absolutely fabulous and he remained my dentist until he died (18 yrs.) After only 2 months or so of TPI in my head and TMJ - all the pain was gone. The face was another story and I continued to need injections for years to get it into remission. It finally worked. However, it did return and I'd have to get booster inj. He was just wonderful and truly with out the TPI, I would not be here today. Having been in his office and waiting room I have learned much about them after 24 yrs.
In the past 24 yrs. I have had TPI from my feet to the top of my head. I must say they all helped to put the pain into remission.
I now am fortunate to have another Dr. who is equally as good at the injections and find relief with him as well. It can be a long process and the pain comes and goes. Don't give up! I would try TPI with a verty reputable DR. Be sure they know who Janet Travell is - she is the woman who we can thank for the TPI and has a book instructing Drs. how to do them. I would not be without her wonderful book. I think it iscalled Myofascial Pain Treatment.
Just google her and you can learn all about her,
Good luck
Sydney

You are right...
 

I am sure the right doctor makes a great deal of difference.

The Orthopedic Surgeon, who injected my back, really hurt and it took several days to get over it. The Podiatrist, probably did not use a needle anywhere near the size the surgeon used, but it did hurt.

The first time I saw the pain management doc, who I go to for occasional TPI, I expected the same thing, but it was totally different, more like a tiny bee sting. He said the difference was that he uses a very, very fine needle. Sometimes, when I go, I get my husband to draw a circle on the areas that need injecting.

I feel sorry for him, because his treatment has gotten him so much attention and business in our area, that his hand is bothering him from so many repeated injections all day. I don't know if that is carpal tunnel or what, but when I go, I go early in the day, so I can get him when he is fresh... :)

Cathie

Hi, I had the injections done yesterday. They did hurt while the med was being injected for sure. I feel some relief (cervical radiculopathy) but there is one spot that hurts more then it did before the shots which is leaving me just as uncomfortable as b4. Dont know if its supposed to be sore afterwards. I also get migraines now and then and before the headaches start i get wavy liquid in the center of my eyes that work their way out to the sides in about a 45 min period and when they are gone the headache is there. I dont get it often but about a half hour after the shots it happened so it made me a little nervous. Yorkiemom I live in brooklyn too wonder if its the same doctor. I also have yorkies lol 3 of them. Barbara

Hello Barbara
 

I can't say I have had the eye symptoms you describe, but I get plenty of others. I am in the Dallas area; the TPI website I posted was for Melody and her husband Alan, and it was in Brooklyn...

There is always some pain after TPI, and it may take a couple of days to ease off. I think the worst one was after the epidural, when the doctor shot me up and when the needle hit its target, I got a sciatica like pain shooting down one leg. It was gone fairly quickly and the epidural helped tremendously...

Cathie
P.S. In order not to hijack this thread, I am sending you a PM... :)

Ah ha!
 

So it isn't just my imagination. There are times when the pain is worse than others. Nights when it's hardly noticeable and others where I'm going crazy. I'm not sure what causes this for me. Increased stress perhaps? Whatever it is it's really aggravating never knowing what to expect til I actually get into bed for a bit.

Had my first lidocaine infusion today
 

I have severe fibromyalgia and a pinched nerve in my lower back. I have been treating with a pain specialist for 6 years. He is great! I take methadone and oxycodone for pain. My regular doctor prescribed 5% lidocaine ointment for topical use several months ago. It works very well. I told my pain doctor about it and he suggested that I have lidocaine infusions. So, I had the first one today. It hasn't done anything so far. It did make me feel "out of it". Luckily, my daughter went with me, so she could drive me home in case that happened. I guess these infusions work for approximately 2 weeks. I guess I will have to wait and see. I saw where others said that it was not very good, etc. I don't know. I just thought I would put my 2 cents in.

I hope you get some relief from the infusion, I have been getting them for over a year now and although they don't take the pain away completely they give me lots of good days. I am always out of it for a few days afterwards, although I am so tired by the time I get them that maybe it is just sheer exhaustion. The first three days I still get pain but it is only on the surface of the skin, it burns immensely and then the pain lessens.
My pain doc has seen patients whose pain has gradually disappeared and I can say one foot(which used to be my worst is now a lot better than the other).
Remember not to overdo it too much when you do feel good as the pain can come back with a vengeance, I wrote a sort of blog last year if you want to read it just look at my old threads.
I get around 3-4 weeks relief now but only have the infusions every6-8 weeks which is a living nghtmare as you know there is a treatment but in the UK I can't get access to this.

If the lidocaine ointment works, why not try the patches called Lidoderm? They are less invasive than an infusion.
I've used Lidoderm for years. They are very nice.

Mrs D, I have had a strange experience as the Infusions are good but the patches don't work at all, in fact they worsen my condition( maybe I am not inserting them on the correct place)

It is possible your PN is more generalized? But yes, if you put them where you feel the pain...on the extremity, they may not work. If a whole leg is involved, putting on the back where the nerves come out of the spine often is better. People with diffuse burning pain all over the body would do better with the infusions I would think.

Here is my thread on placement. Check the 3D graphic link:
http://neurotalk.psychcentral.com/sh...light=Lidoderm

You know, I've tried all sorts of configurations with the patches and also the lido + prilo lotion, but no, nothing. I even try them now and again because...I don't know, I guess I think that this time, maybe it will help. I do the same with Tramadol. None of it really does help, but I'm just, you know, checking every few weeks.

Are you sensitive? I ask because those patches increased my pain too but I feel it is because I am so sensitive that even a light touch on or near my pain area I can't handle. That is why I ask.

I had lidocaine infusions as well though and it seemed to increase my pain. I am not sure if that was a fluke or not of the day

Yes Daniella I am touch sensitive but I don't think that was the problem, it is hard to explain but it was as if the patches switched on all my nerves at the one time so they were doing a dance to themselves:)
The infusion does increase my pain levels initially but that eases off after a few days and I get relief.

Lidocaine makes me far worse as i posted here before, even topically, its not so much the pain as suicidal anxiety for me.

Ive never had an infusion of it though .

m

Ok Maybe Mrs D or someone else could answer and I am sorry this is off topic a little. Lidocaine infusions are used for PN but why not ketamine infusions? They are being used for RSD and I know PN is different but I was just curious.

Mala how many times did you try the patches? I tried mine multiple times so I know my increased pain was not a fluke but sometimes it is just a flare up. Maybe you could ask for the cream or this just may not be the med for you and maybe discuss alternatives

I think ketamine is more often used in Europe:

http://www.neuropathie.nu/medicatie/...sche-pijn.html

I think it is used more for RSD type neuropathic pain, which is slightly different than PN.

........................................

YES YES YES !!! I have a lidocaine infusion once a month and it's AMAZING!!!

River (didn't know where to post this)

Nancy

I don't care where your info is coming from but I have severe PN and get lidocaine infusion once a month at the hospital and it works miracles for me!

I go to ambulatory care at the hospital and they hook me up to an IV on the back of my hand, my veins are best there, I sit for about an hour and for the next month I'm pain free. Oh I may have bad day or two but that's nothing in comparison to what it was. The room has about 6 people getting the same thing. We sit around and chat or watch TV. I also take Gabapenten 3 times a day.

Maybe being in Canada makes a difference but lidocaine is my life saver. I can't understand why some doctors say no. I've been on it for almost 2 years now.

Please push for this.

River :hug:

I would love mine once a month but am now fighting with my local hospital as they say it is too expensive and I will only get it every 12weeks- not good. Although I know it really works now as I have not had an infusion for 8 weeks and I am in agony :(

QUOTE

"malawigirl08 I would love mine once a month but am now fighting with my local hospital as they say it is too expensive and I will only get it every 12weeks- not good. Although I know it really works now as I have not had an infusion for 8 weeks and I am in agony"
.................................................. .................................................. .

Hon I'm so sorry about your situation. I guess that's the difference between medical care in Canada and in the States. We have a form of insurance they have in Britain, social insurance, similar to what's being fought in the States but NOTHING like Obamacare, although it is government run. All I need when I go to the hospital is my health card.

For prescriptions all seniors have to pay is $5.00 to $6.11 no matter what the cost of the RX.

My once a month treatments are wonderful. :hug:

Thanks, people think our NHS in the UK is wonderful as it is free to everyone but there just isn't enough money going in to it now ( although when I see what comes off my salary every month I certainly pay more than my fair share grrhhh). our prescriptions in Scotland are free now but we are at the mercy of number crunchers for our hospital care. Sorry for the rant but my boxing gloves are on, next stop is to the politicians:D

No but I had prolotherapy with it back in 99 which is what began my downward spiral.

I doubt its toxicity ( though I did ingest potassium cyanide the year before in 98) which probably didnt help :(

m

As a fellow Scot I have to agree , unless your problems are life threatening or pretty basic , your just going to get told to live with it and some meds, I cant imagine being able to get even a quater of the tests here through National Hell-th Service.

m

Hi I have had two Lidocaine infusions about three years ago, the first one worked for about three days the second one didn't and I had some side effects with the second, the consultant decided to go ahead an try me on the mexilitine, I was fine when I was on the low dosage but when I got to the maximum dose I was passing out and generally felt awful, that was when they thought it was PN I had but my condition has got worse and I have now been diagnosed with small fibre sensory neuronopathy, I have just joined this site in the hope I can get some information about my condition as it is very rare and can't find very much about it. Ihope the information was of some help to you.

Welcome to NeuroTalk:

Neuronopathy is a form of neuropathy, which attacks the cells in the dorsal root gangla.

http://www.penncancer.org/pnd/subpag...1&ss=23&sss=14

Here is our thread on that...http://neurotalk.psychcentral.com/thread147771.html
the first post on this thread explains the new MRI imaging that can be done to visualize this.

Toxins, drugs, viruses and vaccines are thought to be the main culprits. But autoimmune disease and other things may also cause it.

In some people the cells can regenerate, but if the growth factors are genetically missing, this becomes permanent.
Stem cells are being researched for this problem but are not available yet.