Hi, great forum. I have been suffering with osteoarthritis for several years and over the past 18 months things have gotten progressively worse. I have cervicogenic headaches that keep me non-functional for days. Have had facet joint injections in c-spine worked for about a month and wham back to the headaches. They sent me to PT for 16 weeks at 3xs a week, that's 58 sessions, cost me $580.00 in co-pays. They worked on stuff that I did not even have nor did I complain about; shoulder impingement, they wasted 4 weeks on that one. PT helped for my low back pain for a while. But when they started on my neck it became a misery, extensions, retractions and the last straw was when they put me in c-cpine traction on two occassions, elicited extremely brutal headaches.
So I moved onto pain management where they started with the facet joint injections in c-spine, that worked for about a month. Headaches have now returned and I cannot function with them. Spoke to my neuro today and he is recommending RFA. I have read a lot about it and understand the possible side effects and the mistakes that can be made but anything has got to be better than these headaches. I have considered paying out of pocket for botox injections in the nerves actually until I made that statement to the neuro he had only perscribed NSAIDs and PT for the pain.

For anyone who doesn't know facet joint injections are diagnostic as well as therapeutic in nature, if they work then they know the cause of the pain is the nerve at the facet joint if they do not work then that is not the source of pain. The local that is injected wears off in several hours and the steroid they inject can take several days to kick in for the full effect, so if the injections do not provide any relief than your source of pain more than likely is not the nerves at the facet joints. If the injections are not effective they will not follow with RFA, there is no point to it, it won't work.

Oh, the physiotherapist called and left a message "I don't understand why your doctor has not responded to the patient note I sent and the request to continue PT for you." "Give me a call and we will see about getting you back for more PT". This guy didn't want me to have the epidurals in the first place he wanted to extend PT for yet another 8 grueling weeks or longer.

Here's one you will all appreciate: Spoke to neuro this afternoon as PM is on vacation. He has perscribed Tramadol for my head and worsening back pain and on Monday I should make appt. with PM for RFA. I take 20 to 30 mg of Elavil at bedtime for sleep and some pain (from my GP). I ask neuro if the Tramadol can be taken with Elavil, he says sure no problem, I ask pharmacist when I pick up Tramadol if there is a problem with that and Elavil, she says no problem. I read the drug sheet provided by the pharmacist and low and behold YOU CANNOT TAKE TRAMADOL AND ELAVIL TOGETHER can cause seizures and other pretty major problems. Now what do I do, if I stop the Elavil I will go through withdrawl, but the pain is pretty intense so I opted to take the Tramadol this evening and tomorrow morning, if my headache and backache are improved I will need to take at least 10 mg of Elavil. Honestly you can't trust any body with your health these days!

Sharon

My Test Results
MRI C-SPINE
Multi-level spondylosis most marked at C4-5 with right foraminal stenosis by osteophytes. Advance spondylitic narrowing of the C4-5 interspace with anterior and posterior spurring. Foraminal encroachement by osteophytes. Mild narrowing of C5-6 and C6-7 interspaces with mild spurring. Osteophyte on the right at C4-5 attenuates the ventral aspect of the thecal sac but cause no mass-effect upon the cord.

MRI L-SPINE
(Minor Grade I, 5% anterolisthesis of L4 on L5 due to severely degenerated facet joints. Marrow changes at L2-3 reflect DD change. T12-L1 mild DD changes with disc bulge. L1-2 is normal. L2-3 moderate DD and facet changes with disc bulge. L3-4 mild facet degenerative changes. L4-5 mild to moderate dd and moderate degenerative facet changes with left side disc bulge. Mild left lateral recess and left more than right foraminal stenosis. L5-S1 mild to moderate facet degenerative changes.) **This one done in 2006, the one done in 2004 shows the disc at L4-5 "small herniation to the left of midline". They claim the MD in 2004 was probably not well trained in reviewing spinal MRI.

Xray of T-Spine: Degenerative changes fo the thoracic spine, no evidence of fracture of subluxation. (Suppose I should have an MRI done for the T as well)