Steroid blocks and referred pain

[helenlegs 11]

Just need some feed back please. . . . . .
All I can find out about the steroid component of a block is to reduce inflammation, correct? It won't help long term ( as this is what the steroid is supposed to be for . . . long term pain relief) if the nerve is caught in some non-inflamed structure like ss and st ligaments or spasmed (not inflamed) muscle?
The anaesthetic component of the block could have the positive effect of pain relief for a while if the numbed PN areas have pain relief, until the anaesthetic wears off. This can also then be classed as a positive diagnostic test even if the steroid (longer term pain relief) didn't work.??

Also, not about nerve blocks but. . . . . . if a particular spot anywhere on the body is painful and that pain can be created and/or heightened by pressure directly on that spot this can NOT be seen as referred pain as in a brain/spine psychological pain can it?
It must be a physiological/mechanical problem to have such specific direct touch, palpitation pain?

I'm sure anyone having a heart attack and suffered the referred neck and arm pain that occurs then (not heart pain) if the neck or sholder or arm that was painful was pressed the pain wouldn't become worse as this wouldn't be the compromised area??
Haven't had a heart attack thankfully so don't know but can't imagine this to be the case.
I know that I do get referred nerve pain (say pudendal pain,shooting along the path of the nerve ) and when I do find the nerve and press IT HURTS! but that is because the nerve itself is compromised and any additional tension on the nerve creates pain so I do get the referred nerve pain and the actual pressure point pain.

Does this make sense?
All I want to know is steroid any use except as an ant inflammatory?
And can an actual sore spot as described ever be psychological referred pain?
Thanks
Helen

[helenlegs 11]

found his from a medical students blog, http://anatomynotes.blogspot.co.uk/2006 ... -pain.html Random musings of an anatomist turned medical student. The focus is human anatomy: anatomy myths, weird anatomy, anatomy in the news, clinical pearls, etc.

At 11/20/2007 6:06 AM, Ian K said...
Thanks for this post. I've known about referred pain for a long time, but rarely read such an easy-to-understand description of it. I have a question about the quality of referred pain. Would you say that the area where the pain is perceived will also be tender to the touch, or is it just that the person thinks that the area would be painful to touch? And would it feel different to local muscle pain in the area?
At 11/21/2007 1:11 PM, Brad said...
Hi Ian, My understanding is that referred pain generally feels deep and hard to localize, more like muscle pain than skin pain. Good question for a neurologist or someone who has experienced this kind of pain first-hand. I'll leave another comment if I find something interesting... ~Brad

I also think I have confused radicular (nerve) pain (Radiculopathy) with referred pain.
So My question is, can nerve pain that is a psychological (brain/spine) not mechanical problem in a specific area be more painful to touch?
My answer btw is NO. Can anyone tell me otherwise?
H

[Violet M]

Helen, I think your explanation about referred pain and psychological pain makes sense.

All I can find out about the steroid component of a block is to reduce inflammation, correct? It won't help long term ( as this is what the steroid is supposed to be for . . . long term pain relief) if the nerve is caught in some non-inflamed structure like ss and st ligaments or spasmed (not inflamed) muscle?
The anaesthetic component of the block could have the positive effect of pain relief for a while if the numbed PN areas have pain relief, until the anaesthetic wears off. This can also then be classed as a positive diagnostic test even if the steroid (longer term pain relief) didn't work.??

As I understand it the marcaine anesthetic is purely diagnostic because if wears off after a few hours. The steroid is strictly to reduce inflammation but if the nerve is compressed or is impinged on by a ligament or scar tissue, the steroid may temporarily relieve the inflammation but it won't be a permanent fix because after it wears off the nerve will continue to be compromised by the surrounding structures that are impinging on it. I think if the impingement or compression is severe enough the steroid won't even provide temporary relief and in fact a lot of people have a flare-up from it.