I usually post on the fibro forum but I think this question might get more responses here (I could be wrong)!
The Pain Management Center (PMC) wants to try facet injections on me, cervical and lumbar. The last treatment I got there was trigger point injections (with steriods) that did not work at all. (Physical therapy -manual work - works better on TrP than the injections!) I know everything that this PMC does is trial and error...they keep trying different things to see what may help. They have told me that even if something works it will be temporary since I have fibro. The biggest problem is the expense (and the probability of the treatment working, even temporarily). Even with pretty good insurance (I pay 20% of any hospital bills and this is a hospital PMC). Just the visit with the Dr. that was a very brief exam (to verify I have fibromyalgia) and a discussion of treatment options that might help me created a $1300 bill, of which I have to pay 20%. The bill for the trigger points has not come through yet, but it will be more than the "evaluation". I can't imagine the cost of the facet injections, under x-rays. Probably more than $2000.
And then of course they may not help, or may only help for a short time. I have had MRIs, etc and nothing shows any structural issues with my spine. My PT thinks the pain is the myofacial trigger points and my rheumatologist says bursitis while my chronic illness specialist (sort of a pain doc) says I have fibromyalgia. The PMC doc verified fibromyalgia with "devons's diagnostics". Every specialist has their own ideas. BTW, I was original diagnosed with MPD in 2002, fibro in Jan 2007, and did have a bout of bursitis in my shoulder about a year ago when a cortisone shot helped. My worst symptoms are upper back, pretty much the whole quarter of my back on my left side, left arm pain (sometimes with tingling), neck pain all around, earaches (not from infections) on the left, TMJ pain both sides, and frequent headaches. My right side has TrP also but they are "less active". I don't think I have a muscle in my body that does not have active trigger points. My left shoulder has been higher than my right for a few years now. I have been to chiropractors (who have generally made things worse) and several differnent PTs - the one I am with now is the best. I have pain in my lower back also, hip pain (left) and various other aches and pains that are nowhere near the intensity of the neck/ shoulder/back pain
I have tried all sorts of things over the years. Cervical traction helped a couple of years ago but now causes more pain. I use heat, lidocaine patches, various muscle rubs, Soma, Ultram, Klonopin (recently changed from Atavan) and the Rheumy prescribed Roxicet for breakthrough pain because after 2 years I am on the max dose of Ultram and have built up a tolerance so it does not work well.
Probably needless to say I have developed major depression as I am now going through a divorce to top off all of my stressors! And I cannot tolerate any of the 3 classes of anti-depressants due to side effects (and I agree with those who complain about docs saying "you are in pain because you are depressed" - I was in pain long before I was depressed but I will agree there is a connection between the two). The klonopin was recently prescribed as a short term relief for anxiety until an anti-depressant can be found that I can tolerate (sure ... I have had some very bad reactions and am scared to try anymore!)
Sorry for such a long post but wanted to provide as much detail to see if others have gone through or are going through what I am AND get different people's opinions on the facet injections. They scare me physically and financially, especially knowing they could be for nothing. I am not independently wealthy!
I keep getting told to "suck it up" with the pain but that is much easier said than done! Or, "you have fibromyalgia, accept it and move on." I have been trying to just move on. I do normally work full time as a manager but am on short term disability through work (until I can get stablized again-whatever that really means I am not sure). The constant crying at work, panic attacks, and calling in sick got to be too much.
Any inputs on facet injections are especially appreciated.