Radio Frequency Ablation

[ckc747]

Hi.  i'm post 1 week a radio frequency ablation for lower back levels l1 through l5 facet joint hypertrophy. I'm in more pain then before the procedure and.  Oh the othe diagnosis was Central canal and neural foramina are widly patent at Lw-3 3-4 and l5-s1 without disc bulging L4-5 was Central canal and neural foramina are widely patent with mild disc bulging but no disc protusion extrusion.  Questions are: Should I be in more pain 1 week after RFA procedure?  And  does Central canal and neural foramina are widely patent mean stenosis? Can sonmeone plese help me. I can barely walk, I'm wondeing is should see a ortho or neuro surgeon.  I'm really scared.

[philnoir]

RFA treats specific sensory nerves, for instance, the nerves that provide sensation to arthritic facet joints.

There's really no way to damage the results of the procedure -- this isn't surgery. But, you may have increased inflammation and pulled muscles near the site of the injection. These will heal.

Rest, ice, mild stretching when appropriate, use of anti-inflammatory medication will all help you get back to normal.

If symptoms do not improve or get worse, consult your physician.

[lorissong]

I had RFA done on March 20th and as usual I think I've overdone it, I was so ecstatic that I had no pain that I would clean the house daily and always find something to be done that I couldn't have done before.  Which included heavy lifting and stupid overdoing it type things.  Now I'm back to being on the couch with ice packs.  My question is "did i screw it up for life now".  I am now trying to take it easy, but it was so hard to do, when I felt GREAT for the first time in 35 years.  I was in a POW camp in Iran during 911, was married to a terrorist and didn't know it.  My book is on my website if your interested www.loris-song.com But THIS IS NOT a PROMO post it's to try and relay the injuries I sustained in that camp, I'm only 49 and had hip replacements back in 2012.  So can I still savor the pain relief by taking it easy, it hasn't been a month yet, so does the pain get better with time?

[pearl8261971]

I had an RFA four days ago; the first three days my back pain was much worse, but he told me this would happen, b/c the nerves have had trauma to them from the burning.  He said it would take 2-3 weeks to get better and he gave me Morphine and Percocet instead of Morphine and Lortab.  I have had really good success with it so far, even down into my feet where I have a stress fracture and heel spurs.  I am going to get the left side done on the Dec. 20 and I expect to be up and moving and feeling fine probably by the new year.  Even though there was pretty bad pain after the procedure, it was nothing I couldn't handle b/c I have had back pain for about 20 years so to me it was just going through another procedure to hopefully get some relief, which I have after 4 days of recovery. I have also had these in my neck, which went fine and I suffer from debilitating migraines; henceforth the strong drugs.  

Hope this info helps, but it is different for everybody.  

[Flybackwards2801]

Had 3rd in a series of three spinal ablations. This last one was worse post ablation pain ever. He must have hit another nerve or bundles of nerves ias the pain is excruciating & is worse each day. It's been one week ago today & I can barely walk. Now the nerve pain has traveled down my left leg & seems to "bloom pain" in my left knee. I don't understand! Doctor wants to see me Friday at 2pm. I don't know what he can do at this point. All I want to do is scream & cry. I take morphine ER for pain (ha! Doesn't help much), a very strong muscle relaxer, & neurontin. Needless to say I'm doped up most if the day & night. Crying & moaning from the pain is what wakes me up at around 1:00 am. Then it's torture to try to fall back to sleep. I just do to know what to do. Ice packs alternating w/heat doesn't help. This procedure was done by  my pain control doctor who is also an anestheologist. Any suggestions anyone?

[Turptx361]

I have had several rtf,which have been very successful. Maybe you need to talk to MD about other pain management options.

[lsm123]

are you suppose to have sharp in you neck after having the RFA.

[Ell_bell_13]

I just had RFA in my left C1-C5. After the local anesthetic wore off I felt like my neck and shoulder were on fire for about three days. I took time released pain meds and regular pain meds every 4-6 hours. I have no more pain!  I can even turn my neck. I'm having the other side done tomorrow. I don't know how long the relief will last, but after six years of chronic neck pain I'll take any relieif I can get. I realized this procedure doesn't work as well on others, but imbibe if the success stories!

[ckc747]

Hi.  Well its been about 7 weeks.  Sherry and Braveheart, I hope you are doing well after the RFA's.  PAMPAM and Squirtatious, I hope you guys are ok. I've been busy working from home and trying to come up with a way that I can commute to my job.  Since I can't walk now, I bought a Mobility scooter.  But I still needed something for the car to get me to the train so I can commute to downtown with the scooter when I am finally released from Work from home status.  I am looking into a lift with a vendor and this process is turning into a nightmare in itself.  It amazes me how much the disadavantaged are literally takend advantage of.  It is terrible.  Anyway about the RFA.  I guess it was a failure.  I saw the PM on WEdnesday the 9th. He wanted to do another and I can't right now.  My job is under transition right now and I start the new one on Monday.  So, he is doing some more Facet Joint Injections. He has also informed me that is not much else he can do for me. So now what.  Where do I go from here. I am depressed.  Three months ago I was able to walk for 45 minutes and ride a bike for 30 and work out and take care of my house.  Now I can only stand for 7 minutes and walk for 3 minutes and can no longer clean my home.  I need to mentally adjust to my reduced quality of life.  But it is hard for me to accept. I also realize it could be much worse. Thank you for your advice and caring.  I will post again in a few.  

[namnam46]

PLEASE don't give up the faith that this will work. It's so very early still. I know it seems like a VERY long time until the 6 to 8 weeks are up for the nerves to die off, but it will get better for you. It's ashame that your doctor didn't prepare you better for what was to follow so you wouldn't worry.  Mine made sure I understood what would happen in each stage and emphasized that it would take 6 to 8 weeks for the nerves to die off. Therefore, I wasn't worried with what followed.

I went for my followup yesterday for my first RFA in March and it's really doing great. I'm absolutely thrilled. I'm lucky that I already have 100% relief on my right side which is just 4 days short of 30 days and 85% to 90% on my left side. The other pain from that side is from a botched hip implant in 2005. I'm getting a MRI on Friday to see what damage is being done to my muscles from the improper placement of the pins. When I go back to my PMP on the 2nd of June we'll have the results of the MRI and know what to do about that.

Try to be as patient as you can. I'm so glad that you are being able to work from home, even if it's just for a short time, so that you can take it easy for as long as possible. Even though this is an outpatient procedure your body has to have time to get over the shock to it from the ablation.

Thank you for keeping us updated because we are truly concerned and thinking of you. If you need anything please let us know and we'll try to answer any questions that we can.

Take care and Hugs to you...Sherry

[braveheart2]

I am so sorry that you are still in so much pain, and I completely understand your fears and frustrations as I am myself 8 days out from my own lumbar RFA procedure. It is incredibly hard to try and be patient with the process when we are still in so much pain, although I think your MD's nurse is correct -- all the research I have done estimates that it takes anywhere from as little as 3 weeks to as long as 8 weeks for the nerves to die and the pain relief to come:

From http://www.medscape.com/viewarticle/718292:
"Following the lesion, the tissues demonstrate scar formation; first coagulation, followed by acute inflammatory reaction, necrosis and collagen deposition. The process takes 3 weeks."

You are probably still in the acute inflammatory reaction phase, so no wonder it hurts! With healing time of course there is individual variation, combined with how lucky we were that our anatomy allowed the MD to get the RF wires in the right place to start with -- I have read that for best benefit, the wire needs to be placed within 1 millimeter of the nerve that is supposed to be burnt -- so it's a fairly delicate procedure, considering the MD can't see the actual nerve on the fluoroscope but only the adjacent bones in his/her best effort to get the right spot.

My hopes and prayers are with you that you will soon pass through this phase of healing and move on to the next phase of pain relief. Keep the faith -- it sounds like you had good results with your pre-RFA nerve blocks, which gives you great odds that this will work for you.

Hugs and healing thoughts to you.

[ckc747]

Hi.  this ic CKC747. Thank you for your concern and notes.   I'm now 2 weeks post RFA.  The soreness from the procedure is gone all the bruising is gone too.  So I'm doing better in that aspect.  But regarding the procedure -- not so well.  It has not worked yet.  I cannot bend, walk or stand yet.  I miss my old self. when the PM just did the injections.  I have called his office twice now.  Once the first week, the same day I joined this forum,  His nurse gave me Soma for 4 days and told me to resume the pain meds with the Naprelan.  And then this week to ask when shoud I start to feel relief, I am not feeling any relief.  his nurse called back and stated that the nerves start to die on the 2nd week and that the RFA;s are not considered failed until 6 weeks have passed.  I;m very luck that my job is leting me work from home right now,  I don't know how much longer that will last.  Tomorrow my husband is seeing this same Dr. It think I may go with.  My foll up FRA appt is 4 weeks and 3 days post RFA. I'm very disgusted, in a crap load of pain and am very scared and dperesed. I am praying allot.right now.  

[braveheart2]

Thank you so much for the encouraging words! You are giving me fresh hope that the future might bring less pain. For me, the first set of medial branch blocks (at left L4, L5, and S1) gave me complete relief for a couple of hours -- what a heavenly experience; I felt young again! The second set of blocks gave me about 80% relief for almost 6 hours but she had only blocked L4 and L5 -- she did mention that S1 can provide up to 15% of the innervation to L4 and L5, which seems to be true in my case.

I had torn 3 discs and damaged my left L4/5 and L5/S1 facet joints about a year and a half ago, and nothing prior to the medial branch blocks had given me any relief -- I had tried PT, exercise, NSAIDs, oral steroids, facet steroid injections, and epidural steroid injections -- so I feel like this is my last chance to get my life back with the RFA procedure. So far, my original, familiar sharp stabbing pain is still there ... but today perhaps the "knife in my back" feels like it has a slightly narrower blade. I do still have a tingling and burning sensation on the top of my left foot, but I think this is from the largest disc tear at L4/5 -- there seems to be a chemical radiculopathy of the L5 nerve root from that -- but I don't expect the RFA procedure to change that sensation, and it is certainly liveable.

I will try to be patient, and will keep you posted on my story as it unfolds. Blessings and hopes to all of you for less pain.

[namnam46]

I had several days where I was REMINDED periodically by my leg and back that it was still there LOL. Yes, it would hurt on and off. A couple of times that first week it acted up. But for the most part after that it didn't. EXCEPT, once last week it hurt more than usual but not like it used to.  But it will start to dull down.  It can take up to SIX WEEKS for the nerves to die off. Just be patient it will get better. I've hit the 4 week mark now on my left side and the  3 1/2 week mark on the right side. I don't remember feeling this good. I'm realizing just how much pain I have in the rest of my back now that the HORRIFIC pain is gone. It hurt so much before that it overrode that pain. However, it is very manageable, I can certainly deal with it thanks to the Fentanyl 50  and Oxy for BT pain.

With the wonderful result that you had with the Medial Branch PLEASE don't give up hope!!! I know I'm going out on a limb here BUT I PROMISE you that it will get much better. BUT DON'T OVERDO!!!! This is VERY important!!! It must have time to heal.

Please keep in touch and if you want ANY more information PLEASE contact me ANYTIME!!!

[braveheart2]

Once the local anesthetic wore off a few hours after your RFA, did you have a few days/weeks of your "familiar" pain before that pain began to go away? I am 3 days out from a 3-level lumbar RFA on April 27, 2010 and am feeling my usual sharp stabbing pain, same as before the procedure. (I had an excellent response to 2 sets of medial branch blocks before the RFA, so was very hopeful this might give me some relief).

I am scared and depressed that it may not have worked ... is there still hope?

[namnam46]

Have you called your Dr. that did the procedure and told them what you are going thru?
You should get in touch with them right away to let them know. They might be able to help you.

I had the procedure done in three places on my left side on March 28, 2010 and 3 places on the right side on April 8, 2010. I'm very lucky because I  have had only wonderful results from it. My pain is 95% gone already.

I'm hoping that by now you are feeling much better and are having the same great results I'm having.

It can actually take up to 6 weeks for the nerves to completely die. I tcan last anywhere from 3 months to 18 months or longer. (Some have had relief for 24 months.)  

Keep your positive attitude and PLEASE check with your Dr. that did the RFA if you are not feeling any better. Who did your RFA?  Your Pain Management Dr. or an Orthopedic Dr. or a spine Dr.

My Pain Management Dr. who is an anesthesiologist who specialized in Pain Management took care of mine.

Please take care and post again and let us know how you are doing. We all are thnking of you and are concerned about you.

Best of luck. Looking forward to your next post--- Sherry

[ckc747]

Thanks so much for replying.  I've done alot of reading.  probably too much on the RFA.   I trust my PM.  I'm sorry PamPank that it only worked for yo for a few months.  Bummr for  all the pain that you go through for it.  I'll post back in a week or maybe sooner. From what I read, some perople feel relief in about 1 week - full relief in 4 weeks.  I'ff remain positive.  And that it can take 2 weeks for the nerves to die.  Some people have to have a second procedure to feel relief.... Talk to you guys soon. hopefully with good news.  Its like 60 % people it works on, 50% don;t need to have it repeated.  And the nerves can grow back in as soon as 3 months.  Take care

[squirtatious]

I've heard this procedure can take awhile to heal from, that it isn't a "instant fix". Take care

[pampamk]

I had the same procedure and I hurt worse after to the point i could hardly walk and it lasted 3 months it did help that I told the pain management doc that did it how bad it was and it did help when he gave me a steriod shot to help it but the procedure only helped for a couple months after it got better. I also used a heating pad and it helped. I as well lost sensation in some parts of my behind I got it in my lower back.