Getting TMBB Nerve Blocking done to spine in a few hours to L4 5 6 7 8 9. Will let you know the suck after.
Wow. Surprised that your insurance lets you do that many levels at once. Every place I've reviewed caps at 2 to 3 levels bilaterally in one session.
No idea what that is but sounds complicated. Good luck.
It is where they inject a medical nerve blocking agent into the spine that blocks the signal of the nerves to the brain.
It is used to determine if extreme long term pain is caused by joint fractures in the spine or if it is muscular/other.
The blocking agent lasts for a few hours and if my pain goes away in that time then the damage is spinal. If it doesn't it is something else.
3 years of horrid numbness or real real pain it was time to move on from pain meds which I did in November.
For each vertebra they will inject until they hit the spinal column then back it off and "melt or burn" the nerve but not really, it is a chemical reaction I am told.
A little more background because I do prior auths for these all the time, and pain management injections are one of my favorite things to geek out about.
Back pain is generally caused by one of three things outside of trauma/fractures (often people have "mixed pathology," multiple problems at once):
1) Basic, generally superficial
muscular pain. This usually responds well to good posture, physical therapy, etc. This is why insurance usually asks for a month or two of PT before MRIs, surgery, etc. -- to make sure the pain isn't just muscular.
2)
Radiculopathy, which is cased by nerve root impingement (a slipped disc or something else is pushing on/causing pressure on a nerve.) This usually results in pain that radiates and neuro deficits like reflex changes, sensory changes, potentially strength changes in the limbs along the path of the impinged root. This is usually treated by epidural injection or decompression surgery to free up some space around the nerve root.
3)
Facet joint (Z-joint) pain, which is caused by arthritis in the joint and generally produces a deep, achy, non-radiating type pain that is worse with twisting and bending side to side and usually no neuro deficits. Facet pain is generally treated by either steroid shot into the joint (just like any other kind of steroid shot into an arthritic joint like a knee) or with radiofrequency denervation (RFA), where the nerve near the joint that is conducting the pain signal from the arthritis is burned off. Some pain management specialists also use chemodenervation (with chemicals), cryodenervation (with cold), but generally the only modality that is covered by insurance is heat/radiofrequency.
A person generally needs to undergo two sets of MBBs which just contain lidocaine, bupivacaine, or some other -caine local anesthetic to make sure injecting that level actually stops the pain. If it works once, you do it a second time, and if the second time still helps, then you're good to either get the therapeutic injection or RFA depending on your/your provider's preference.
