nerve blocks

[Guest guest]

Kristy,

The pain dr. did not say if it was a nerve root block or a facet joint

block. There is no one else in my area to get a 2nd opinion. There is no

pain when the Q-tip test is done. The burning, stinging pain occurs when I

sit or have my knees up in bed. It's the result of a waxing that went awry.

No pain occurs around my groin and it does not radiate down my leg. It is

on both sides but mostly on the left. It is better in the A.M. but

deteriorates in the P.M. as the stress from the day wears on. Stress

aggravates it so much. How can I tell if it's the genitofemoral nerve? Has

anyone ever had success from having a nerve block? Is it covered by

insurance?

[Guest guest]

Sue,

If you have pain in the upper part of your vulvar area like

close to where it meets with your leg (this is also the area

where the groin is) and the pain radiates down your leg those

are clues that will let you know if it's the genitofemoral

nerve. One way I knew it was that and not the pudenal nerve was

when my Pain Management doctor tried to block the pudenal nerve

with the trigger point injection not once but twice and did

nothing.

Also, with the pain of the genitofemoral and also ilioinguinal

nerves the pain in that area can be really sharp like as if

someone is poking you in that area.

If you get an infection do you notice more pain, like it's so

bad that the only thing will help til you get antibiotics is

something like narcotic painkillers? For me, I get this when I

get even an infection like a yeast infection. I can't just

depend on the discharge the way most other people can.

Sometimes if the infection is bad enough the pain will radiate

in to my groin (which is part of the lymph system too).

When you sit down do you feel the pain around the labia minora

or around the bottom part of the vaginal opening? Do you feel

any pain in your foot too when you lift your knees?

When I was researching the block that was suggested there was no

one that had it done to that area specifically on the spine for

this problem. When I read up on the kind of blocks that are

used by Interventional Pain Management doctors (their technique

is much more different than a regular Pain Management doctor who

does trigger point injections like mine does) it gave quite a

bit of detail of what's involved.

As for whether insurance will cover it, they may if they agree

with the doctor's reason for doing it depending on how much is

necessary to prove Medical Necessity (this is especially the

case for those that still have HMOs).

I don't know which area of the country you live in but if you

are close to a big city I would recommend asking your primary

care physician to help you find another doctor to get an opinion

from to see if an injection would be a good idea because there

are other ways to deal with this besides injection.

Also, if you are on meds right now if you do have this block

your doctor may ask you to hold off on meds that have helped

some of your pain for a few hours to see if they got the right

area.

Have you ever had an MRI done of your spine, in particular the

lower areas that cover the lumbar and sacral areas? I had this

done back in Feb and it found that two of my nerves were

narrowed. Also, problems with the lumbar or sacral areas being

out of alignment can cause pain in the vulvar area just like

back injuries which is why I ask if you have ever had an MRI of

your lower back done.

Keep an eye with those positions if you notice any pain going

toward the area of your leg where the vulvar area meets up with

the leg at the top part of the area (the genitofemoral is a

branch of the femoral nerve which is why if there is pain with

this nerve it can radiate to the main branch which is why I ask

if it has ever radiated down your leg). Check to see if it's

sharp like as if someone is poking you with a needle. Also,

keep an eye to see if you notice any numbness in that area (with

the pain issue I've had for the last 10 months I have had

occasional numbness in that area that would last for about 10

minutes or so as part of the process in addition to running down

my leg but also down to my foot and out) or if the pain radiates

down your leg such as when your knees are up. See if it goes

down your foot too.

Keep a pain diary to help you keep track of what you notice so

you can share it with your doctor.

And most important of all ask this doctor if the kind of block

he wants to do is a trigger point injection (which really

doesn't block nerve at all which is why they often don't last

long as I found out toward the end of the last 3 years that I

tried them), nerve root block (where they are covering a bigger

area and actually getting to the nerves such as very close to

the spine) or a facet injection. If it is one of these last two

there is a possibility of infection.

They call these kind of blocks paraspinal nerve blocks.

Hope this is of some help but please keep researching and get

some more opinions with the help of your primary care physician

because blocks are not the only way to deal with chronic pain

associated wit this condition.

If you have other questions for me please don't hesitate to ask.

You can e-mail me privately as well.

Kristy

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