MEDICAL CORNER …… Pain Management … Update!


~~January 13, 2014~~

Today I had my second visit to the pain management provider.

I do need to say that since my first visit on December 20, 2013 there has been considerable improvement. Not to say that the pain is gone but the intensity has improved to tolerable levels. The pain is still there …..

I thought that when I went today, after my report, the doctor would say “let’s observe for a while and let’s have another visit in a few weeks to see how you are”. That wasn’t the case.

My doctor is a great guy …. he’s well informed, extremely organized and has an excellent bedside manner. He has the steps already charted and knows what the management plan is. “If this doesn’t work, then we will do this” …..

Today he was glad because there was improvement when compared to our fist encounter.


This is a link to the first post related to my medical condition.

I had an MRI done which was reviewed with my primary care provider.


Small, left sided posterolateral disc protrusion at L5-S1 causing some narrowing of both neural foramina

Bulging disc at L4-5, L3-4, L1-2 and T12-L1

Dextroscoliosis with global disc dessication (drying up, loss of hydration), degenerative end plate changes


Needless to say, this looked ominous!

The first step in his management plan was identifying four facet joints in the lumbar spine using fluoroscopy and injecting cortisone and a numbing agent.

It wasn’t that bad. You go to a specially prepared room. They position you on your abdomen and using a special Xray machine, he located the joints that he was working on. 

It all went well …. I was home within a couple of hours.






On January 3, 2014, I posted more information related to facet joint syndrome and what it was doing to me physically and mentally.

Facet Joint Syndrome is a problem with movement of the facet joints of the spine. If one of the joints becomes stiff or too mobile then inflammation and pain is often the result. The facet joints are delicate structures that form the links between the vertebrae of the spine rather like the links of a bicycle chain.


What causes Facet Joint Syndrome?

Usually the cause of facet joint pain is trauma. This can be a single major trauma, like a car accident or a fall, or a repetitive minor trauma caused by, for instance, poor posture, bad lifting or even long periods sitting down.

The core stability muscles of the back and abdomen may also have become weak, perhaps by lack of exercise. These deep muscles protect the spine during normal movement and act like shock absorbers. If they are not doing their job then this may lead to the spinal joint dysfunction and pain.

Our genetics may also play a role. If our spine is not perfectly formed or is slightly twisted then subtle stresses put more pressure on the back joints and may lead to facet strain and cause pain. Sometimes the discs of the spine may not be as healthy as they should be and this can put extra loading on the facet joints too.



What does the condition feel like?

Pain from facet joint arthritis is usually worse after resting or sleeping. Also, bending the trunk sideways or backward usually produces pain on the same side as the arthritic facet joint. For example, if you lie on your stomach on a flat surface and raise your upper body, you hyperextend the spine. This increases pressure on the facet joints and can cause pain if there is facet joint arthritis.


Pain may be felt in the center of the low back and can spread into one or both buttocks.

Link to that post below:



Today we talked about progress, options and about the plan for the visit. 

The doctor explained again that there were steps to follow. He was glad that the initial treatment had been successful. Even though the pain was still present, it had lessened in intensity and had allowed for my quality of life to be a bit better. 

We decided to repeat the procedure ….. facet joint injection. This would be the second and the last time.

If this doesn’t take all the pain away, then we go to the next step.


This is a graphic of the actual procedure.


Image found with the fluoroscope machine. Needles already in the facet joint.


The other side. 


Today is a landmark.

This is the second round. This is the last step of this phase. I have to schedule physical therapy again and have a follow up appointment in three weeks.

Today, I feel fine. The effects of the “conscious sedation” have considerably lessened. I’m walking around the house and it feels fine. 

Let’s keep hoping that this will all work.

Today, I’m thankful. 


We ALL are ONE!!


Facet Joint Steroid Injection


…. and that is what the doctor did!! 


We ALL want to be PAIN-FREE!! 


This entry was posted in Equality and tagged by Dr. Rex. Bookmark the permalink.

About Dr. Rex

I'm originally from Puerto Rico. I was born in Santurce and raised in Rio Piedras. Have lived in Florida since 1999. I have a doctorate degree in Medicine; completed in 1976. My Internal Medicine specialty was completed in 1979. Worked for Puerto Rico's health system until 1985. At this time, I'm happily retired after working for the federal government for almost 28yrs. I want to offer any knowledge that I have to anyone "out there" who is interested. My views are liberal in almost every sense. My knowledge is "eclectic" - a bit of everything. Music and reading are my passion. Blogging has also become a very interesting endeavor. Metaphysical topics attract me. I'm interested in news reporting human issues like injustice, discrimination and abuse - the "wrongly" affected. My intention is to bring this knowledge to an understandable level and to help anyone in need. I'm open to questions and will answer them to the best of my ability. Currently working on an enterprise whose main mission will be to bring peoples of all walks of life together. To be one .... since we ALL are ONE!! The future looks bright and promising!!!

7 thoughts on “MEDICAL CORNER …… Pain Management … Update!

    • TY Bill … and I consider myself lucky. Have been reading about other bloggers that are really having a hard time with chronic pain.

      TY for your get well wishes!! Peace … 🙂


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