Discussions By Condition: Kidney conditions

kidney block for pain?

Posted In: Kidney conditions 4 Replies
  • Posted By: nails_100
  • January 19, 2009
  • 10:46 AM

Has anyone ever had/heard of a kidney block for pain? I spoke to 1 person that had one by an Interventional Radiologist and it was CT guided, Lidocain was injected. Have not been able to find info on line....Anyone???

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  • Are you sure they didn't say a Nerve Block?I can't imagine blocking the kidneys for any reason, but a nerve block is useful for pain in some occasions. It can be done with a an ultrasound or a CT--any imaging device. Lidocaine is one of the drugs that can be used. Sometimes steroids are injected into the nerve to promote healing and lessen inflammation. The nerve root may also be permanently destroyed if the pain calls for it. What kind of pain are you experiencing? I would talk with your doc about all this and see what he/she says. Nerve blocks are only a piece of the puzzle when it comes to pain management, in my experience.
    Harmonium 322 Replies
    • January 19, 2009
    • 05:30 PM
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  • Ok, so is it possible to do a nerve block on kidney? My 18 year old daughter has kidney pain, Thin basement Membrane disease, and passes Brush ite ( had to spell that in 2 words WD thought it was a swear) stones. They have also found a 5mm "spot" on her L3 pedicle. Biopsy for that came back negative. Had steroid shot in spine area 2 times- didn't work on pain. She has severe pain lower back area. On narcotics, muscle relaxers, lyrica... has not been to school in 5 months. So Kidney or spine???? Kidney docs say spine. Spine docs say kidney. My thought...block kidney- if pain stops its kidney, if pain still there its spine. here is the only info I have found about "kidney block" not a doc so not sure what it all means.....:) PROCEDURE:The above findings were discussed with the patient and she stillchose to proceed with the left renal pedicle block. Therefore, thepatient was placed in a prone position with helical scanning of thethe central portion of the kidneys. An appropriate location wasdetermined and a 22G Chiba needle advanced to the the positionedimmediately caudal to the left renal pedicle. Intermittent CTfluoroscopy was used. Once the needle was in appropriate position, atotal of 35 cc of 1% lidocaine was injected with intermittentimaging. The needle was removed and helical imaging was thenperformed to the kidney.The patient tolerated the procedure without incident. This attendinginterventional radiologists performing tear procedure The patient wasdischarged a half hour following the procedure. She was instructedto the e-mail me this evening for my follow-up of her symptoms.FINDINGS: Imaging demonstrates a advancement of the needle to theappropriate location andadjacent to the left renal pedicle withprogressive opacification of a pararenal fat centrally by thelidocaine. Several air bubbles are noted secondary to the injection.Follow-up imaging demonstrates no evidence of pneumothorax orhemothorax. Opacification of the pararenal spaces noted. There isno evidence of bleeding.The patient noted relief of her symptoms approximately 5 minutesfollowing injection of lidocaine. However, the symptoms returnedonce the patient returned to an erect position over the next 15minutes. Patient was discharged with slightly improved but recurrentleft flank pain.
    nails_100 22 Replies
    • January 20, 2009
    • 10:27 AM
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  • I am not a doctor. I do have a tiny bit of medical knowledge, although my knowledge is book-learned rather than practical. I do hope that some docs chime into this discussion. It is my understanding that it is indeed possible to do a nerve block on the kidney (field block with splanchnic nerve). I have heard of the block you describe, but the splanchnic one, from what I understand, is more common. However, given your daughter's age and that the spinal injections did not work for your daughter and that there is no consensus between your docs, I doubt they would agree to this. Nerve blocks to major organs (or really, in general) can be dangerous. At the very least, they are only temporary. You state that you are just trying to determine if the pain is coming from the kidney or the spine, but I'm not sure if this block would help you do that. It does block the pain signals from the kidney, but depending on exactly where the block is placed, it can block much of the whole area.There are also signifigant risks to this-- postural hypotension, pneumothorax, and lymphedema to name a few. The block is given to the greater and lessor splanchnic nerves just outside the vertebral column above the diaphragm, as I understand. Your daughter is only 18 and to be suffering so much with all this is terrible. Please, push your docs to find a diagnosis that gets results. I know from experience that any kidney stones, no matter the type or size, can cause severe pain. These must be dealt with. I know that the bru****e's reoccur commonly and quickly, but how are they treating this issue? As far as the 'spot' on her L3 pedicle, get a second opinion. It can't hurt. FWIW, I have a few of my clients over the years report 'spots' on their spine with no pain and no adverse issue. However, each case is different and should be fully investigated. You don't say what bloodwork has been run or even exactly where her pain is. Is her pain over the top of her hips or in the spinal column itself? Is it a dull, aching pain or sharp, stabbing pains? Is the pain constant? Does she have trouble bending or moving in any way? Does it hurt her to urinate? The kidney pain--is it only one one side, which side? What is your family history of kidney disease? These things matter and may help others help you. I know personally with chronic pain, sometimes the 'cure' can be as bad as the pain originally was. As in, you hurt so you lay around a lot and take narcotics and muscle relaxers. That's all well and good....but at some point your body gets accustomed to the meds and begins to get re-bound pain just from the meds. Then there's the pain that comes from just not being active. LIVING TISSUE MOVES. Please, I know your daughter hurts, but keep her up and moving. It will help in the long run. Best wishes to you. Keep posting, maybe giving some more info on your daughter's labs and specific pain. Others here can help.
    Harmonium 322 Replies
    • January 21, 2009
    • 03:06 PM
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  • First- thank you so much for posting back. Unfortunatly there is no family history for my daughter, both my husband and myself are adopted. For 3 months my daughter passed the brush ite stones every night (vomiting and pain) she has been taking potasium citrate to help. She is now on 30mg daily and only passes stones about once a week no more vomiting but still pain. She has alot of scar tissue in right kidney, from prior infections, but pain with the stones is actually on left side. However only hurts her kidney when she is going to pass stones. And she says it feels like she is "peeing razor blades" She feels the stones move. She also insists that kidney pain and back pain are seperate. Her back pain is constant. Wakes up a 6 level by noon is a 7, by 3:00 at an 8 level sometimes even higher by bed time. Her pain is very focal. A burning/ stabbing pain. Hurts even to touch. One doctor had her put a pain marker on her back and did an xray. It was 6mm off of the spot on her L3 pedicle. I would say slightly left of the spine. Pain does not move up or down or radiate to legs, no tingling or numbness. She does have full mobility upon exams. Most blood work and labs have been done for kidneys no thyroid issues or igg... CT scan of abdomen and pelvis all normal. Both ureters flow properly. Other than the 5mm spot (this week called anomaly) Her MRI from 2 days ago is fine.Orthopedic Surgeon said there is nothing "structualy " wrong with her and it may be a tissue problem- he hopes pain clinic can help. He said he is "stumped". Again- no diagnosis. We are way past "2nd" oppinions. 3 Urologists, 3 Nephrologists, 1 Neuro Surgeon, 4 Orthopedic Surgeons, and 1 Chiropractor. Thanks again for replying
    nails_100 22 Replies
    • January 22, 2009
    • 10:18 AM
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