I believe a diagnostic block is just Marcaine and short acting. A therapeutic block adds steroid and is longer lasting. Often Drs want to do the diagnostic block before therapeutic or ablation/rhizotomy.

My scalene block was marcaine and a little bit of steroid. It didnt last long at all.

I saw Dr. Jordan today and we looked at my c-spine mri again which shows bone spurs and the disc bulge pushing into a nerve and narrowing the foramina.

He is now recommending a transforaminal nerve block with steroids and stimulate the nerve as a diagnostic to see if it reproduces the pain. This will help decide if the disc is causing any of my shoulder and scalpular pain. If it does reproduce the symptoms then he will do pulsed radiofrequency to help with the pain for 6 months. Even though we dont think the pain is coming from the disc,I guess its worth doing if it will help rule it out.

I feel better about doing this one then I did about doing the BP nerve block as my shoulder pain is worse than my arm pain. I may feel better about doing the BP one later if this one isnt so bad. Hopefully it will tell me once and for all if the disc is responsible for any of the pain. All the surgeons want to rule this out first too. He didnt mention the facet block this time,but I think he was responding more to what he saw on the MRI.

I went ahead and asked them for a pre auth since this will take a few weeks to get anyway and it will give me some time to think about when /if I want to do it. Dr. J says he does them all the time and I have to trust that he is one of the best at doing these.

I told him I was going to try the neural prolotherapy that Dr.Aufiero recommends but he doesnt think it will do anything since i didnt respond to the trigger pt's but it is so much less invasive than any of these other injections and insurance will pay for the first one so I dont really see the downside.

He also gave me the name of an innovative pt that he recommends closer to me: Li-der Chan and a Chiro- Joe Horrigan. Anybody heard of these? I havent reseached either of them yet but that is next on my list.
He respects dr. Ando and says he is go to guy in Orange County. Its too bad he didnt give me those names earlier, because I am going to stick with Ando for awhile but for long term I will need to find treatment closer to me.Plus my pt visits have run out. I am in the midst of trying to ask for more but my insurance almost never approves it.

Everytime I see him there is so much to talk about and even though he spends almost an hour with me I always have more questions. ITs $200 everytime I go.

I have had the transforaminal lumbar block and it was effective. It is also easier (fewer needles) than the medial branch (facet) block. I hope it brings you some relief. Spinal issues are much easier to deal with than TOS in my experience. Is Aufiero or Jordan going to do the injections?

This is thru Dr. Jordan. Dr. Aufiero just does the neural prolotherapy which I will probably try first. I like the idea because it is diagnostic and it will be good to know once and for all if the pain is just the TOS or not. I hate being experimenting but I guess every procedure is.

I am still feeling better since starting to see Dr. Ando, so maybe I wont even need to do these,but my goal is to start working part time in July and then hopefully go back to my regular work in the fall and that will certainly be a challenge. The chin-tuck exercise is really difficult for me and gave me bad shoulder pain, I have to talk to him about it when I see him tomorrow.

Think this is the chiro guy?? Interesting

[Joseph M. Horrigan, DC, DACBSP, CSCS
Dr. Horrigan is the President of Horrigan Sports Chiropractic and Soft Tissue Center. Dr. Horrigan served on the American Chiropractic Board of Sports Physicians for seven years, of which four years were as Vice-President. He served as the Chair of the Written Examination Committee for nine years. Dr. Horrigan was awarded the 2001 Sports Chiropractor of the Year. Dr. Horrigan also served as the Head Speed-Strength and Conditioning for the Los Angeles Kings for three years. He served as the Team Chiropractor for the Long Beach Ice Dogs hockey team for several years and as their Director of Speed-Strength and Conditioning for seven years. Dr. Horrigan serves on the Medical Committee for USA Weightlifting. He served as the Chief Medical Officer for Team USA for the 1999 Junior World Championships and 2003 World Championships in Weightlifting. ]
http://softtissuecenter.com/about/st...r-Joseph-49575

Thanks, I looked him up too. It sounds like a big place, ofte you dont get to see the main dr. in these places They are right by my house so I'll give them a call. They are out of network with my insurance so will see how much it costs,but its worth in my search for a non-traditional chiropracter. Dr. J says he knows about TOS.