[exercise453]

#6216

Hi Doc,

I am reading the entire forum and learn something daily. It answers long standing troubling questions. I have come on one I wondered about and find no answer.

It involves your remark about x-rays:
“DMX or fluoroscopic X-rays are generally not recommended with diagnosing instability as the dose exposure to X-ray is significant and the information can be gained by standard positional X-rays with much less X-ray exposure”

In an arthritic neck, with numerous trauma and a yet unknown degree of nerve irritation, and multiple pain generators I think my pain management experience was disjointed, with extra blocks leading to a c3-8, then c2-3 radiofrequency and one epidural. The results were minimal. Especially the c3-8 block and radiofrequency involved long stints with the fluoroscopy machine (30 plus minutes 3 times).

More educated now I am considering a new pm doc, targeted at c2-4 facets and another epidural. I have worried and read about these x-rays and after a lifetime of caution I’m exposed to long sessions and maybe more to come. At the same time I am learnind the limits of what can be accomplished for neck pain and at what cost.

Are the x-rays worrisome and how much is too much or too often??

I take Ultram (2x50mg daily) and an average of 1200mg Advil daily (more or less). It cuts the pain level from a debilitating 6-7 in half to about a depressing but functional 3(ish) With all the hoopla about pain management they are having parades if they cut your pain in half.

At some point, or at least for a period of time, if the medication (no side effects) gives the 50% pain reduction does it become a reasonable or even better choice??

Thanks doc

[Donald Corenman, MD, DC]

#6218

X-rays in moderation are generally acceptable. That case I was discussing was constant fluoroscopy for a long period of time (DMX motion fluoroscopy) and I am not a fan.

The rhizotomy fluoroscopy should be on/off images and expose you to significantly less x-rays. Even if your time on the table was prolonged, the exposure should not be.

50% pain relief with your medication regime is acceptable in my opinion.

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.

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