Back Pain and Pain Management

Today, I headed up to the North side to see a pain management doc. With my recent back issues, I got some temporary relief after a visit to Urgent Care.

With that visit, I got about 5 days worth of steroid pills. Today, I had a consultation to see how I might manage things a bit longer, and reduce the inflammation so I can start work to strengthen my core/back/muscles more.

An interesting note: my doctor’s office was located near an assisted living facility. So as I walked in and found my way, I passed by a ton of senior citizens who were sitting around in chairs… waiting. And I could swear I heard them all whispering to me “One of us, one of us” as I walked by.

In the waiting area, a somewhat disturbing liminal space. I guess this is better than seeing the place chock full of sick and injured people.

Some artwork.

I met with Dr. Engel, and really enjoyed talking with him. He explained things to me in great detail, and was genuinely interested in answering all my questions.

I felt at ease talking with him, and to be frank – felt like he was someone I wanted to go grab a few beers with. I really liked meeting him.

After looking over my MRIs, he recommended an injection to handle the discomfort/inflammation. As he was listing the potential risks, he said something along the lines of the fact that there was a 1% chance of infection, Meningitis, and paralysis.

On hearing “paralysis,” that caught my ear. He clarified, and said that these were warnings he had to give out. But that the specific brand of injection he uses has never had incidents of paralysis.

I asked a bit about pain and discomfort, and he described the process as involving some pain and “pressure.” And sometimes, patients will sit in the waiting room for about 15 minutes before they can head out.

I asked if I would be ok to drive home after the shot, and his reply was “If you can’t drive home, we’re both fucked.” Like I said, I really liked the guy.

We walked to a nearby room for the procedure. I’ll admit, I was pretty nervous.

I didn’t change or anything, just laid down on my stomach. There was maybe 5-10 minutes of prep where I couldn’t see anything, which added to my stress. But overall things weren’t too bad.

The initial sting of the needle was sharp, but fleeting and over in a minute.

From what I could surmise, Dr. Engel was using some kind of machine to take x-rays, to see about the placement and location of the needle. At one point he said “it’s good where it’s at, but I want it great.” So there was some adjusting.

He also mentioned using contrast, which I assumed helped him to see where the injection would go when dispersed. He did this two times, I think.

When this happened, it felt like a lot of pressure running down my right leg. Imagine the feeling of heavy water filling your veins, and then getting stronger and bigger inside your leg. That’s kind of the sensation.

When he was ready with the injection, it felt the same… but steadier and longer. As it continued, it grew in pressure and intensity. He asked me how I was doing, and if I wanted a break. I paused for a few seconds, and then said “Yes, I want a break.”

The moment I said that, he replied with “Oh good, right when you said that I’m done.” And it was over.

I struggled a bit to actually roll over on my back, and to get off the table. When I tried to sit up, I felt a lot of pressure on the base of my spine/glute… and couldn’t really do it. At the doctor’s suggestion, I took my legs off the table, and was able to sit up (with his assistance).

Here are the x-rays from the procedure.

And a close-up of where the needle went in. Yikes!

Dr. Engel mentioned to me that I was probably his 35,000th injection (or thereabouts). Never been so happy to be part of such a mundane statistic.

On my way out, I could feel some discomfort… but nothing that prevented me from walking and going back to the car. While I can understand how some people might want to sit and recover a while, things were just fine for me.

Overall, it sounds like it’ll take a few days for the full effect of this injection. And my next steps, hopefully, are that when I feel less discomfort… I can resume sessions with my chiropractor. And work on strengthening things, so that this doesn’t happen again.

Related:
At the Urgent Care
Lower Back MRI
Back Issues