Has anyone had Anti-inflammatory injections in neck for relief of ES?

Please can anyone tell me how this procedure went for them and whether it brougth them any relief...I am frightened to death to have this done...the doctor said he has only done 2 others before me but he sounded quite competent and sure of himself...so I am at a loss..I am very scared...please anyone...tell me if you have had this done and whether it helped....also if you can give the name of the doctors who did the procedure in UK and how long it took...were you sedated?? any information...please

Good Morning Bermudiana, Let me loan you my experience with injections. I am currently in the injection cycle. It's the left side of my face that ES is killing me. After my first set of injections it help for about 10 days with little to no pain. He also gave me a script for 120 oxycodones to take when I feel the pain coming on me. After the 10 days I was taking 4 oxy's a day sometime 5. I had a visit 7 days after my 1st round of injections. Now I'm getting injections once every 2 months, with a script of pain meds. It has caused me to put on 12 pounds after getting injections and I have heart failure and my heart doctor is not happy. My advice is to try it at least once time and see for yourself if it works. If he uses cortisone with your injections, expect some weight gain.

Hello Bermudiana,

I have had this sort of treatment for ES on several occasions. The last time was earlier this year. I have seen Mr. Prad Murthy at North Manchester General Hospital, Manchester, since 2007. He is absolutely excellent. In my case (which was more a vascular sort of ES) his theory was that the misaligned and thickened styloid process was impinging on structures and setting up inflammation. This includes the carotid artery (which would explain the this is the very loud pulsatile tinnitus I used to have). He does an injection of steroids and lignocaine into the tonsillar fossa. This is the tonsil area in your throat. Mr Murthy has seen quite a few people like me and has had success with this treatment for many people with symptoms like mine. The average time the relief lasts for his patients having this treatment is 18 months each time. He repeats the treatment when it wears off. The idea is that the tissues are given the chance to heal and become less swollen and irritated. I have had this treatment on 3 or 4 occasions. I got a year out of it a few times, and only three months on one occasion. I think the latter may have been due to a less experienced person doing the injection rather than Mr Murthy himself. The injection is done under general anaethetic, as a day case. Dr. Murthy sees it as a straightforward procedure. I have no problems with it, other than a little soreness in the area. I am very pleased with the procedure and Mr Murthy. I did try to find someone to remove the bone (including going to Guys Hospital London), but couldn't find anyone who would do it due to the risks and complications that can occur. My Murthy would not do a removal for this reason. The situation would have to be very serious to justify it. I decided in the end I wouldn't want to take that risk either. If this injection is the procedure you are referring to, I don't think you have need to be at all frightened or concerned. It is very simple in the scheme of things, and just a short visit to hospital if you are a day case. You are welcome to message me if a chat would help.

Kind regards,

Janine

Not in favor of injection TX . drugs not touching pain.ES just came back again after 4 months without pain.Suffering since 2009.Want MRI to see why it came back so hard. Still taking the anti seizure med. Good luck to you.Thank You



Janine Talley said:

Hello Bermudiana,

I have had this sort of treatment for ES on several occasions. The last time was earlier this year. I have seen Mr. Prad Murthy at North Manchester General Hospital, Manchester, since 2007. He is absolutely excellent. In my case (which was more a vascular sort of ES) his theory was that the misaligned and thickened styloid process was impinging on structures and setting up inflammation. This includes the carotid artery (which would explain the this is the very loud pulsatile tinnitus I used to have). He does an injection of steroids and lignocaine into the tonsillar fossa. This is the tonsil area in your throat. Mr Murthy has seen quite a few people like me and has had success with this treatment for many people with symptoms like mine. The average time the relief lasts for his patients having this treatment is 18 months each time. He repeats the treatment when it wears off. The idea is that the tissues are given the chance to heal and become less swollen and irritated. I have had this treatment on 3 or 4 occasions. I got a year out of it a few times, and only three months on one occasion. I think the latter may have been due to a less experienced person doing the injection rather than Mr Murthy himself. The injection is done under general anaethetic, as a day case. Dr. Murthy sees it as a straightforward procedure. I have no problems with it, other than a little soreness in the area. I am very pleased with the procedure and Mr Murthy. I did try to find someone to remove the bone (including going to Guys Hospital London), but couldn't find anyone who would do it due to the risks and complications that can occur. My Murthy would not do a removal for this reason. The situation would have to be very serious to justify it. I decided in the end I wouldn't want to take that risk either. If this injection is the procedure you are referring to, I don't think you have need to be at all frightened or concerned. It is very simple in the scheme of things, and just a short visit to hospital if you are a day case. You are welcome to message me if a chat would help.

Kind regards,

Janine

Thank you for responding Janine and taking the time to write all that you did...I am deeply touched...however I am very nervous about having this done..Spoke to Dr today who called to explain the procedure and he told me that the needle would be guided by the CT so as to avoid my artery and veins as this is a risky procedure to do and that I could be sedated to help me but not asleep!! So I am unsure as to how this will help me and if I should proceed to do it because at moment at least I know what I an dealing with but I don't know what will happen after I have this...and whether or not I trust someone who has only done it twice!! Dont know what to do

Janine Talley said:

Hello Bermudiana,

I have had this sort of treatment for ES on several occasions. The last time was earlier this year. I have seen Mr. Prad Murthy at North Manchester General Hospital, Manchester, since 2007. He is absolutely excellent. In my case (which was more a vascular sort of ES) his theory was that the misaligned and thickened styloid process was impinging on structures and setting up inflammation. This includes the carotid artery (which would explain the this is the very loud pulsatile tinnitus I used to have). He does an injection of steroids and lignocaine into the tonsillar fossa. This is the tonsil area in your throat. Mr Murthy has seen quite a few people like me and has had success with this treatment for many people with symptoms like mine. The average time the relief lasts for his patients having this treatment is 18 months each time. He repeats the treatment when it wears off. The idea is that the tissues are given the chance to heal and become less swollen and irritated. I have had this treatment on 3 or 4 occasions. I got a year out of it a few times, and only three months on one occasion. I think the latter may have been due to a less experienced person doing the injection rather than Mr Murthy himself. The injection is done under general anaethetic, as a day case. Dr. Murthy sees it as a straightforward procedure. I have no problems with it, other than a little soreness in the area. I am very pleased with the procedure and Mr Murthy. I did try to find someone to remove the bone (including going to Guys Hospital London), but couldn't find anyone who would do it due to the risks and complications that can occur. My Murthy would not do a removal for this reason. The situation would have to be very serious to justify it. I decided in the end I wouldn't want to take that risk either. If this injection is the procedure you are referring to, I don't think you have need to be at all frightened or concerned. It is very simple in the scheme of things, and just a short visit to hospital if you are a day case. You are welcome to message me if a chat would help.

Kind regards,

Janine


Gosh this sounds like a hopeless situation to actually live through...I just feeled doomed :( You sound like youve gone through much worse...I have had no treatment as of yet..and I am petrified to also...at least i know what I am dealing with right now..but I won't know if they will make it worse or even worse kill me! Its hard to fatham allowing someone to guide a needle into your neck albeit through CT so they know where they are going but still...who has only done this procedure twice...how can I even consider this to be an option!
cleverasi said:

Good Morning Bermudiana, Let me loan you my experience with injections. I am currently in the injection cycle. It's the left side of my face that ES is killing me. After my first set of injections it help for about 10 days with little to no pain. He also gave me a script for 120 oxycodones to take when I feel the pain coming on me. After the 10 days I was taking 4 oxy's a day sometime 5. I had a visit 7 days after my 1st round of injections. Now I'm getting injections once every 2 months, with a script of pain meds. It has caused me to put on 12 pounds after getting injections and I have heart failure and my heart doctor is not happy. My advice is to try it at least once time and see for yourself if it works. If he uses cortisone with your injections, expect some weight gain.

Bermudiana,

I can understand your concerns... has Mr Corbridge explained why he wants to try this rather than just have the operation to remove the styloid, when he's done that before with other patients? At the end of the day it's your neck, and your choice, and sometimes at a consultation you can't think of everything to ask. It might be an idea to clarify why he wants to try the injections. There might be a valid reason, which might put your mind at rest.


He said from what I can remember that he wants to try the injection to see if I get any relief and that will give him an answer and if I don't then that would give him another answer! But that he didn't want to jump into surgery straight off and not knowing exactly what the situation is as far as less invasive techniques first - I don't know what to do because it all sounds very scary...at least I know what I am living with now..but I don't know what I will be like after injeciton or surgery!! This is very very sad. :((((((((((((((((((
Jules said:

Bermudiana,

I can understand your concerns... has Mr Corbridge explained why he wants to try this rather than just have the operation to remove the styloid, when he's done that before with other patients? At the end of the day it's your neck, and your choice, and sometimes at a consultation you can't think of everything to ask. It might be an idea to clarify why he wants to try the injections. There might be a valid reason, which might put your mind at rest.

Hi Bermudiana
I am exactly in the same situation as you.
I will ask my doc if it is possible with cortisone pills or spray. Maybe there is another option but I think it is unlikely. I will ask my doc at the end of this month.

Hello Bermudiana,

I understand there to be a hierarchy of interventions. So initially drugs (e.g gabapentin or amyltripyline) will be offered to dampen the nerve activity to stop pain. Then an injection would be a step up from this. The approach used with me was infiltration of the area, which I assume was more allowing the injected liquid to filter into the area rather than putting a needle a long way in. I can see why the doctor would do it the way being offered to you. This would get the drugs near to the base of the styloid where structures are close together and being irritated etc. The next option up would be to shorten or remove the styloid process. While removing the styloid has been reported to relieve symptoms in some people, it is risky due to the proximity to major nerves and vessels. There are also reports of people having some problems afterwards. For example, instability of the jaw due to the insertion points of the ligaments being affected. Whether the surgery is done intra or extra orally does involve dissection of an area with many important structures. Hence this being a treatment of last resort where the benefits would outweigh the risks.

Why do you have to be awake and just sedated? Why can't you have a general anaesthetic for this procedure? I'd ask this question if you haven't already.

What is your diagnosis in terms of problem with your styloid process (e.g. too long, broken, odd angle, pressing on something like a nerve or blood vessel)?

I also have osteopathy on my neck, and the realignment of the neck vertebrae seems to help with the ES. Things are all interconnected.

Kind regards,

Janine


My styloid is fractured! I just dont know if i want to take any risk at this point!! I remember when i was having myofacial release on my neckand i found some relief in that but i just dont trust anyone anymore to touch my neckn :((((
Janine Talley said:

Hello Bermudiana,

I understand there to be a hierarchy of interventions. So initially drugs (e.g gabapentin or amyltripyline) will be offered to dampen the nerve activity to stop pain. Then an injection would be a step up from this. The approach used with me was infiltration of the area, which I assume was more allowing the injected liquid to filter into the area rather than putting a needle a long way in. I can see why the doctor would do it the way being offered to you. This would get the drugs near to the base of the styloid where structures are close together and being irritated etc. The next option up would be to shorten or remove the styloid process. While removing the styloid has been reported to relieve symptoms in some people, it is risky due to the proximity to major nerves and vessels. There are also reports of people having some problems afterwards. For example, instability of the jaw due to the insertion points of the ligaments being affected. Whether the surgery is done intra or extra orally does involve dissection of an area with many important structures. Hence this being a treatment of last resort where the benefits would outweigh the risks.

Why do you have to be awake and just sedated? Why can't you have a general anaesthetic for this procedure? I'd ask this question if you haven't already.

What is your diagnosis in terms of problem with your styloid process (e.g. too long, broken, odd angle, pressing on something like a nerve or blood vessel)?

I also have osteopathy on my neck, and the realignment of the neck vertebrae seems to help with the ES. Things are all interconnected.

Kind regards,

Janine

How do you know your styloid is fractured? Did it show on CT?

Oh... hmm. Yes, I had them and they were life savers; they also gave credibility to my diagnoses. However, it has to be done with absolute certainty. Discuss this with your dr. If you trust him, go for it. My ENT was fairly new when I started getting the shots. But they are well trained. Is he in with other drs? At least he told you his experience and didn't play games.

What is the name of the medication they want to inject?

My injection was into the nerve right under the ear. Ask them to show you exactly where, etc. I was not sedated; it is just like getting an injection at the dentist.

No pills, spray, massage will work. Only numbing the nerve.

I was so ready for relief, I cried because the pain was gone almost immediately.

Glad you got good results for it Ladygw! It's strange how it's helped some people and not others!

Ahh...I am just wondering if this is a different kind of procedure your doctor is offering Bermudiana. I went to Guy's Hospital at one stage and they referred me to their pain clinic. The said they would offer me the use of some gadget I could take home to attach on your neck in some way. I believe it runs an electric current through into the glosspharangeal nerve to stop it sending pain messages. However, I was not pleased to find after travelling down (from Manchester) they were planning to do a different technique. I can't remember the name of it, but it involves putting a wire through the wall of the throat (in the tonsillar fossa area) and sending an electric current into the nerve. The name might involve ablation. I was shocked when asked to put on a gown, go into an operating theatre etc. when I had thought I was just being shown how to use a gadget at home. When I found it was something else, I said I would give it a try as they didn't have the other machine to give me and I had travelled a long way. Apparently they had decided to do a different procedure due to the machine not being available for me - but didn't think to discuss this with me or offer me the option not to come down. The procedure was aborted as I had no sedation and couldn't cope with someone trying to insert a needle in my throat and get it to touch the glossopharangeal nerve. It was absolutely awful. They did apply some anaethetic spray, but that really doesn't help. Separate from all this - nerve pain from that nerve is not my problem anyway. They said they hadn't done that proceudre for ES before. So I was a guinea pig. They were not pleased I would not go through with it. This procdure is usually used on other parts of the body such as knees I gather, for long term intractable pain.

Re the injections I now have. The steroids reduce irritation and swelling. The theory behind this is that structures in the neck, including the carotid artery, are rubbing against the bone. This sets up swelling and inflammation, which causes pain and other symptoms such as tinnitus. The lignocaine - I guess that is to stop pain for a period during and after the procedure. So on that theoretical basis, the treatment seems to offer some help to me. The fact it does woudl suggest the consultants theory has some mileage. It is also no problem at all to have as you are under general anaesthetic when they do it. I can't imagine anyone coping with any procedure such as an injection or similar intra-orally in the tonsillar area, under sedation where you are awake.

Kind regards,

Janine

Hi all :slight_smile:
Again I’m amused by how similar all of our experiences are…
hospital had a cancellation and invited me to go for my ‘injection’ today for glossopharyngal nerve block. didn’t have time to research and thought it’d be like having jab at the dentist. Asked to put the gown on and was prepared for ‘surgery’, off to the theatre and team of people waiting for me with their lead lined coats, they pumped several drugs into my hand, pain killer, anti-sickness and light sedation (moddazalam I think), was having a chat and all was relaxed, just a slight scratch on my neck behind my ear and the Dr asked me to tell him when I could feel the tickle on my tounge which was sending a pulse down to a metal patch stuck to my leg, then he knew he was in the right spot so then sent in the drugs. I only saw the wire once they pulled it out which was rather shocking, but I can honestly say it was a breeze. Feel bit grotty this evening just due to sedation and my neck is numb, that was my objective! :slight_smile:
I’m also booked for hypnotherapy to try and break the cycle of me thinking of the ‘thing’ in my throat.
I strongly recommend Mr Rogan Corbridge for Eagles patients in UK, I saw him at the Circle Reading Hosp this week which was on NHS via chose and book through my GP, everybody should be entitled to this.
Dr Atherton from pain management at Queens Hospital Essex did my injection today.
Wishing everybody well.
Regards
Sue x

Thanks for letting us know how it went, Sue- hope that it helps you long term!

Hi Ladygw, really happy you had such great relief from the injections. Could you please let me know what medication was injected? Seems to be different types. Thank you!