[exercise453]

#7229

Hi Doctor Corenman,

Two additional question please. You have said facet pain can mimic the nerve (c2-3, c3-4). Aside from pain, can a degenerated facet via the medial branch nerve cause all of the other possible nerve symptoms such as irritation, burning, radiating and numbness???

You mentioned facet capsule tear. If this is the case is pain management the treatment (radiofrequency) or does this become a surgical issue???

Thanks Doc

[exercise453]

#7230

Tightness….I forgot tightness

[Donald Corenman, MD, DC]

#7233

The pain generated from a facet problem at C2-3 can cause three types of symptoms. First is local pain right under the skull. The second is headache type of pain that radiates from the base of the skull over the skull or around the ear. The third is a pain that can radiate to the mid neck and possible into the top of the shoulders.

Irritation, burning, tightness and numbness can occur from facet mediated symptoms.

Facet capsular tears are rarely a surgical issue.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[exercise453]

#8924

Dear Dr…..18 months ago I had what I have since learned from the website and forum was a poorly diagnosed left c3-8 radiofrequency with minimal results. It uncovered a symptomatic left c2-3 which was radiofrequencied two months later with good but short lived pain relief. While there are other pain generators below I have long believed and been fixated that having c2-3 and c3-4 radiofrequecied together would make a big difference. I am also educated to identify the less than miraculous pain relief that might be achieved.

I found a castle connelly-beckers list IPM and of course he does not “burn” above c3(c2-3) because of “ataxia seen afterwards”. Since the previous doctor never injected cortisone with his medial branch blocks because it was a “long standing condition”, I went along with left a c2-5 facet cortisone injection. There was no pain relief at all.

I communicated again to the doctor that I want c2-3 and c3-4 medial branch blocks simultaneously and radiofrequency if significant relief. I am not sure if he will do it but he said that because the cortisone injection produced no pain relief at all that a radiofrequency would not produce significant relief at these levels.

Is he right that the cortisone injections are telling or should I press on for c2-4 medial branch blocks???

The c3-8 radiofrequency 18 months ago produced minimal, short lived pain relief and better but short lived for the added c2-3 radiofrequency two months later. I have symptoms at these levels but does the fact that they were radiofrequencied two months apart even matter or does this tell you the c2-4 blocks and radiofrequency will fail and I should give up on this???

Thank You

[Donald Corenman, MD, DC]

#8926

The cortisone injection should have included lidocaine or another type of anesthetic in the solution that was injected. If so, then no temporary relief would indicate to me that the facets are not the source of the pain. I would not push to have another rhizotomy if the injection did not yield relief.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[exercise453]

#8930

But doc, that’s the problem. There was no anesthetic, just cortisone. This doctor is saying that if a just cortisone facet injection did not yield relief then it is not the facet. Dating back to the radiofrequency I described last post 18 months ago there was short lived relief but the two levels were done months apart.

So is this doctor correct that a cortisone only injection with no near term or short term relief eliminates the facet or must it be medial branch blocks with anesthetic for a proper diagnosis.???

If there is some involvement from both c2-3 and c3-4 facet could the previous radiofrequency have provided only minimal-short lived relief because they were done 2 months apart as opposed to together. Could the failure be from the 2 months apart???

Thanks again

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