[annapurna]

Good question, I'm really wondering that right now as my second intra-articular was also very negative (NO pain relief, at all). I asked my sports med doc who was giving me the injections as my three-level medial branch block in July had seemed somewhat positive. Aside from just a straight-out false positive (between 25% and >50% for single facet blocs of any kind), the medial branch blocks are a little different. Turns out that the medial branch nerves ennervate more than just the facet joints (surprise, surprise). They also ennervate some deep spinal muscles that contribute to stability and can get pulled and irritated, etc. When doc's check for the effectiveness of a rhizo, they often do an EMG on those deep spinal muscles. Based on this fact, I'm wondering whether a part of my apparent positive in July was due to anesthetization of those muscles? The other thing that's making me think that this last set of injections was accurate was the fact that the apparent epicenter of my pain is much lower than my facet joints. I could feel where things were numb from the shot, or the facet capsule felt a bit pressurized from the lidocaine/maracaine mix, and my normal pain was not anywhere nearby.

My next step now is to start looking at other pain generators such as ligaments, muscles, and the SI joint.

Laura