radio frequency ablation

[bigdonkey1]

I have been battling meralgia parastethica for 6 months with cortisone shots, and even a neurplasty to relieve the nerve impingement with no relief. I can get some limited relief with the coritsone shots, but it wears off and i am right back where i started, back with this debilitating leg pain.
The dang Doctor is now considering radio freqency ablation to deaden the nerve transimission of pain. i am concerned with the side affects related to this radical procedure.
Question, has any one had this procedure? and if so how did you do with it?
any suggestions on what type of DR should do this? pain management DR is who I was referred to for this.

any suggestions and feedback would be greatly appreciated

[atonicat]

The nerve pain has gotten better. I no longer have the "sun burn" feeling. I just have numbness and pain if the area is touched as well as the electric shock feeling. The shocks are the worst since they come out of no where and literally make me cry out. I have to rub my thigh or even hit it when it happens to make it stop. Walking makes the shocks come on more frequently. I was just at the grocery store and had quite a few shocks which is sort of awkward in public since I'm standing there hitting myself!

Honestly the RFA has been the best thing I've done so far, even with the nerve damage. Prior to having it done I was in constant pain from my lower back. I was taking Celebrex for my arthritis, after being on ever NSAID's known to man. As well as Norco for the pain. I also used a TENS unit constantly as well as having heating pads in my night stand and my desk at work. I was in bad shape. After the RFA, I'm able to do almost everything I was able to do before as long as I don't do too much at once. Like today I steamed cleaned my couch and I am paying for it now. It's still no where near the pain I was in before. And when the pain does return I will have the RFA repeated.

You're already ahead of the game by asking all of these questions and doing research. That's what I do before I get any procedure done. I usually search Google for what I'm going to have done and include the word "forum" in my search so I can get discussions on forums from people who have gone through what I am about to. It really helps to hear from people who have gone through the same things.

Let us know how this all turns out. Living with CP ***** but it helps to have people to talk to about it.

[bigdonkey1]

yes, i use them alot, it is the only thing that deadens the extreme pain. the patches can only be used on 12hours and off. but i use them when it becomes unbearable. which is more and more these days.
but i need something more than just treating the symptoms but it would seem that there are really nothing that can be done except the ablation. i relented to the decompression surgery since it appeared that it would resolve my issue, but it has only made it worse. being no stranger to surgery, it has always helped me relieve whatever painful issue i was having, including two fusion surgeries, both were a success the first time and i really got full pain relief. now i limit my activities to protect my back, but at least i could hike and ride my bike before this issue. now, nothing, i just limp along thru life. cortisone shot to cortisone shot.
i know that the ablation is treating the symptoms as well, but if it can bring some longer relief from chronic pain than just the meds and cortisone, then i am up for it. this CP is damaging (severely) my quality of life these days.
is your MP releasing for you? does your pain go down and become less damaging for you since you are on the lidocaine patches? usually the MP will go away over time, but it has not for me, only gotten worse. none of the medications i am on do enough to lower my pain level in my leg. ice, oral NSAIDs, even oral predisone. but i try to limit the amount of prednisone since it can be so harmful to your body over time.
so.....if the Enbrel does not work to lower my imflammation and decrease my pain, i am going to go for the ablation.
thank you so much for your support, i hope you find some pain relief as well.
Gary

[atonicat]

I had my RFA for facet arthritis in my lumbar spine. Like you, when my doctor first suggested RFA, I was scared. I was actually more worried about acting like an idiot while sedated. I had never had any sort of sedation before so I was more scared of that.

It seems like you're doctors are heading in the right direction. It may sound like a radical procedure but it's really not. I would say that it's more radical when it's done on the spine. Anything done near your spinal cord is dangerous and that's always something I had to take into account before I had my many epidural injections and nerve burns. But these doctors know what they are doing. Especially pain management doctors who do this day in and out.

I did a quick search on your condition and treatment with RFA and I've only read positive results. I can sympathize with you on what you're going through. When I had the RFA done this last time, it damaged my meralgia parastetica nerve. So I literally feel your pain. My doctor prescribed lidocaine patches to help with the burning pain, which does help. Have you looked into those?

[bigdonkey1]

was your RFA for meralgia parastetica? what you said seems consistent with what they have told me to expect. the DR they want to refer me to has supposedly done a bunch of them already with good results. but still it seems kind of like a radical procedure. but considering the amount of pain i am constantly in, except when they do the cortisone shots, anything at this point is on the table.
they want me to try Enbrel first, that it may relieve my terrible imflammation that is causing the nerve pain over and over.
any ideas or suggestions.
Gary, thank you so much for your help and support.

[atonicat]

I had mine done by by pain management doctor. They do it under local anesthetic, a pain reliever (fentenyl)  and a relaxing med, or benzo (versed) is used by IV. It lasted about 30 minutes. They number the area with lidocaine and then insert the catheter needle. They then insert the electric probe. They do a few test pulses to get as close to the nerve as possible. They cannot actually see the neves under x-ray, so when they pulse you're supposed to tell them as soon as you feel it. Then when they are right on top of the nerve, they numb the nerve with lidocaine and then they burn it. You cannot actually feel them burning the nerve since it's numbed.

There are really little side effects with this. The main side effect is local pain and maybe swelling at the injection site for a few days. It's really nothing ice or heat can't take care of. After the local pain wears off, you will probably still have your normal pain until the nerves completely die off. For me it was probably a week or two before I was pain free.

Honestly you really have nothing to loose. You just need to make sure that you go to a pain management doctor who will preform is under x-ray and while you're awake. The reason you need to be awake is so you can tell them if they are hitting a motor nerve. Basically they want to make sure they don't damage the nerve that makes you're leg work. If the doctor say's you're going to be knocked out, run the other way.

When pain becomes chronic, the chances of it going away are pretty slim. All we can do is manage the symptoms and try and live our lives. Pain management is a fairly new branch of medicine and it's growing pretty quickly. But even still there is only so much that can be done.

[bigdonkey1]

Was your RFA for Meralgia Parastetica? has anyone out there had RFA for that neuropathy?
What was the danger of Anathesia Dolorosa from this procedure? is that a real issue that you were warned about? have you had any pain from the procedure? that was caused by the procedure, a side affect?
anyway, thank you so much to all you fellow CP sufferers out there,
frightening how many of us there are out there.

Gary

[namnam46]

Hi Gary,

My Pain Medicine Doctor is an anesthesiologist who is superb in his field. I live in the Phoenix, AZ area and that's where my PM Doctor is located. I only had a local and I didn't feel anything except slight discomfort.  I must tell you that I have a high threshold for pain, if that makes any difference.  

I didn't have any side-effect except for numbness on one side of my leg, I believe it was the outside of my leg.  It only lasted for about an hour.  I could still walk, I just made sure that I stepped on the inside of my foot so I wouldn't fall down and make a fool out of myself.  LOL

You will do fine!!  I'm almost 65 years old and like I said there's NO pain there anymore. After having that pain for almost 20 years it was such a blessing to me!!!  I hope and prya you have the same great results that I had.

Now, I am still on strong pain medication because of the other problems that I have but the pain is gone from my lumbar area because of the RFA.

I hope that answered your questions.  Please feel free to ask anything else and I'll try to answer them for you.

Your most welcome for the feedback..........Sherry  :)

[bigdonkey1]

Oh, thank you for your responses. chronic pain really *****. i have been going for any pain relieving treatments that i can and this seems like the end game. They keep treating the symptoms not the problem. I am a 50 yr old healthy male and to tell me that this may never go away, (as one neurologist told me) seems unacceptable. with all the modern medicine advancements.......really?
did you have any numbness or other side affects other than what atonicat had?
who did it for you? what kind of DR? did you have general or local anasthetia?
it would seem that the literature i have been reading speaks to the safety and limited side affects are small, but with any procedure, i am worried that of the potential side affects.
they just keep giving me drugs or cortisone and it would seem that is a bad way to live my life, particularly since those have limited benifits.

thank you so much for your feedback
Gary

[namnam46]

Hi bigdonkey,

I had the RFA done over a year ago and I'm doing great.  I had it because of Facet Arthritis as atonicat did.  I had both the left and right side done.  I had the left side re-done at one year because I was afraid I would be moving and wanted to be sure that the nerves stayed dead as I didn't know if I would ever find another great Doctor as I have.  The move hasn't taken place yet and so I haven't re-done the right side and it's still pain free after 14 months!!  The RFA's can last from a few months up to 18 even 24 months!! :)

As you can tell I love it and will definitely have it done over and over again.  My pain went away immediately on both sides and never has come back yet.  I hope that you are able to get the same wonderful results that I did as there's nothing that can compare to the fact of being pain free in your legs and your back.

I had the epidurals done on my middle back and neck but they didn't last long and I don't care for the steroid side-effects either.  I definitely get where you are coming from on that one.  :)  

Please don't be afraid of trying them.  Usually, they will try a "practice" block to see if you are a candidate for the RFA (at least they do for the Facet Arthritis).  Then if that works for a certain period of time they will proceed with the RFA.

I wish you the very best and hope that you will keep in touch and let us know how you are doing.

My thoughts and Prayers are with you.........Sherry  :)

[atonicat]

I had RFA done in February for facet arthritis in my last four lumbar vertebrae. I've been almost pain free ever since. Just some pain if I over due it but my constant 24 hour a day pain is gone. It's kind of funny though because when I had it done on my right side it sort of caused what you have now. I don't have what you have but I have neuritis caused by the RFA. It has many of the same symptoms though, numbness, pain, burning, tingling and electric shock feelings that really get me. It's on the outside of my right thigh/hip area. After I had the right side done, I could barley walk with that leg. My hip hurt so bad and I couldn't even put on my pants without horrible pain. I was given a steroid shot which calmed it down, but it's been three months and the neuritis is still there.

This side effect from RFA is pretty rare and should not stop you from at least considering it. The neuritis is nothing compared to the pain I used to have everyday. RFA is not permanent and as the nerves regrow the pain can come back. It does last a lot longer than steroid injections though. So it should definitely be something you look into. There are really not that many side effects of RFA. Steroid shots have a lot more side effects and can have long term effects if you get too many injections of cortisone.