Has anyone had Brachial Plexus Nerve Blocks/Facet Blocks
 

Has anyone tried Brachial Plexus Nerve blocks or Facet Blocks? My Dr. is recommending them to me as botox and trigger pt injections did not alleviate my symptoms in the Trapezius muscles or Arm /Hand Pain. The facet block will tell me if any pain is coming from my cervical disc bulge at C-5/6 and The Nerve block will supposedly help alleviate the nerve pain going down into my arm and pinkie.

I dont know if/which one I am going to do, especially if I am going to do surgery anyway. Would like to hear from anyone who has had them and how they did or didnt work for you. Also has anyone tried Neural Prolotherapy? Thanks!

You might also want to search the spinal forum for info about the nerve blocks.

I did a little bit of research for you. The Brachial Plexus Block is a common procedure for local anesthesia for surgery (performed by an anesthesiologist). After reading about it, I'm pretty sure I had this anesthetic block when I had hand surgery to repair a ruptured ligament (basketball injury) way back in high school. It just numbed my entire arm so it must be different than the blocks used to treat chronic pain.

I did find some information regarding brachial plexus blocks being used for chronic pain conditions:
http://radiology.rsna.org/content/216/3/886.full
http://www.deaconess.com/body.cfm?id=1918

If Dr. Jordan is performing this procedure, I would guess he is using ultrasound guidance which I believe is superior to x-ray/CT guidance mentioned in the articles. Regardless, I'm not sure I would personally opt to have this procedure since it will only provide you with temporary relief and this is such a sensitive area which could lead to complications. It scares me a little, kinda like Dr. Ahn's angiogram/angioplasty.

I can recommend the cervical facet blocks without reservation. I think it is important for you to identify what pain is originating from the C-Spine. TOS is often diagnosis of elimination, while spinal issues are relatively easily diagnosed. You very well may be suffering from double crush syndrome which I was. The facet block was scary for me the first time around just because of the unknown. I have had it done 3 times cervically and once in the lumbar (I have bad discs down low too), in addition to other epidural injections. After the first couple times, I am now able to undergo the procedures with no sedation! It was after my 3rd cervical facet block (and multiple MRIs) that we (neurologist, neurosurgeon, my wife, and me) concluded that my cervical fusion was fully healed and successful and the remainder of my symptoms must be due to TOS.

Thanks I found the same article. I've been researching all day and there is not alot on the bp block. I am definately not rushing into it and am planning to get another opinion or two. I thought I had ruled out the cervical radiculopathy after 3 docs told me they thought my symptoms were from TOS,but I am thinking now I do have "double crush" but I still think most of my symptoms are from TOS. Dont facet blocks just rule out the fact that the pain is coming from the facet joint itself? Also isnt cervical pain constant? Mine is intermittent and today my traps are not hurting as much but the scalenes are.

I would second Marc’s research and advice wholeheartedly. Personally, I have had the brachial plexus blocks for surgeries on both shoulders. The block makes the arm completely numb for 12 to 24 hours.

I, too, have had cervical (and lumbar) facet injections. When the neck was the problem, the injections worked and the c-spine settled down, allowing the doctors to realize there was a shoulder injury. The shoulder was fixed and the neck has been much better since then. I still will need to have a c-spine fusion but I’ve gained several years avoiding the fusion by getting the shot plus it allowed another problem to stand out.

Last year, I allowed a physiatrist do a cervical spine block because she insisted my arm symptoms were coming from the neck (C5/C6). I let her do one spine block which did nothing for the arm. In this case, the block ruled out the c-spine. For me, the scalene blocks and botox shots provided relief both this time and when I dealt with TOS about 8 years ago on the other side.

It would be good to try to rule out as much as possible before committing to surgery; otherwise, surgery may not be successful. The shots are one step towards this. I know several people who were all set to have TOS surgery only to find out that it was a shoulder or spine problem. Another person had two TOS surgeries (same side) only to find out that she really needed her neck fused from C5 to C7.

In my case, the cervical pain isn't constant.

I don't think any nerve pain has to be constant. In my case, neither the cervical pain nor the TOS pain was always constant. I had/have a lot of pain that was initially thought to be mostly myofacial. In hindsight, nerve pain was at the root of it all.

I think TOS is greatly under-diagnosed. When a doctor can't find an answer, they just label you with fibromyalgia or some generic chronic/myofacial pain syndrome.

No, I believe facet is simply referring to the location of the injections. "Medial Branch Nerve Blocks" is the proper medical terminology (and probably the better google search phrase). Facet block is probably just faster to say. I'm pretty sure the medial nerves innervate more than just the facet joints. I believe facet joint inflammation is often secondary to degenerative disc disease. From my cervical facet blocks it felt like I got relief in the scalenes, SCMs, and levators.

Definitely something to talk to your doctors about to better understand. My understanding is likely incomplete.

Hi Sheri, was the shoulder pain from TOS or something seperate? What did you have done for the shoulder?

The botox has helped me somewhat but I still have shoulder and arm pain.I agree with both you and marc about ruling out as much as possible b4 surgery. I put off a spinal epidural before not convinced my problems were disc related and then I got the TOS diagnosis so I put the disc issue on hold. Now it looks like it could be a contributing factor again.I will be looking further into these shots.
Thanks