I had an MRI of my lumbar spine recently at one of the top private hospitals and it identified a variety of potential sources of my lower back pain - from sacroiliitis to narrowed lateral recesses that could be compressing root nerves, enlarged facet joints among others.

I've looked up the efficacy rates of various injections used for 'pain management' as they like to call it. Not very impressive. Most are around the 50-70% efficacy ranges, and they take minimum 1-2 weeks to feel any improvement (if you get any improvement at all)

The various injections are known as:

Transforaminal Epidural Steroid Injection (TFESI),

Bilateral Lumbar Facet Joint Injections, and

Sacroiliac (SI) Joint Injections

These injections are supposed to be done by a skilled anaesthesiologist, guided by x-ray (fluoroscopy) to ensure the needle enters the right spots.

Anyone have any experience with any of these? Recommendations, etc? I know @Sheryl has recommended an ortho/spine doctor at BNH but he's a surgeon, not an anaesthesiologist, and so the experience of these procedures could vary expert to expert.

Prof. Wicharn, the doctor you refer to, has 2 anesthesiologists who work with him and provide these injections. He also works with physical therapists. The fact that someone is a surgeon does not mean they only do surgery. I can assure you from first hand experience that Prof. Wicharn does not recommend ir perform surgery on all patients. Probably not even most.

One does not go straight to an anesthesiolgist for this as the cause of the pain must first be identified. Which takes an expert ortho specializing in spine to do, reviewing scans and Xrays in the context of the clinical picture. Not only can such a specialalist usually identify the source of the pain, he can also assess the likelihood steroid injections will help. Sometimes, if there is doubt about cause of the pain, nerve conduction studies may also be done.

Abnormal findings on MRI are common and not necessarily the cause of the pain. This is why it is so importnat to be assessed by s very experienced spjnal specialist.

The various injections you list are the same thing just injected in diffrent parts of the spine according to the source of the pain.

I have had these injections 3 times, twice in lumbar spine and once in cervical spine. . One helped only for 2 weeks (I then had surgery) and 2 gave what is so far permanent relief. My sister had it once with so far (15 years later) permanent relief.

With all treatments -- injections, physical theraoy, surgery, medications --the likelihood of success is highest if the cause of the pain has been correctly identified.

Even when the injectons don't help, they can be useful in confirming the diagnosis because in additon to steroid they contsin shorter acting local anesthetic (hence my injection that worked for only 2 weeks -- the diagnosis was correct but there was nerve compressed by bone to an extent only surgery coul relieve

Go see Prof. Wicharn bringing thr MRI on DVD with you.

5 minutes ago, Sheryl said:

Go see Prof. Wicharn bringing thr MRI on DVD with you.

Okay thanks @Sheryl for your comprehensive reply and advice. I'll take the DVD to see Prof. Wicharn. Should I take the radiologist report too, or just the DVD and let Wicharn come up with his own review and diagnosis?

Best

R.

I am having problems with my back , since I was young. For 24 years now, I am suffering from Adhesive Arachnoiditis.

In 1999, I had a successful back surgery at Phramongkutklao Hospital in Bangkok.

In the following link, you will find a lot of information, regarding your query. I hope you find answers.

https://arachnoiditishope.com/protocols/

Edited 32 minutes ago32 min by Beat666
Additional Info

3 minutes ago, Beat666 said:

I am having problems with my back , since I was young. For 24 years now, I am suffering from Adhesive Arachnoiditis.

In the following link, you will find a lot of information, regarding your query. I hope you find anders.

https://arachnoiditishope.com/protocols/

Wow. Sorry to learn about that. I hope you have found some coping mechanisms...

3 minutes ago, ronnie50 said:

Wow. Sorry to learn about that. I hope you have found some coping mechanisms...

Yes, actually I am doing pretty well.