Hi All,

I just had the RF done today; L4/L5 and S1 on the left side. I was given Versed and Fentanyl I believe he said but was still alert enough to talk about anything and everything...and believe me I did! I was chatting away LOL! I did not hurt AT ALL! All I felt was a slight tingling and that was it!

I came home put ice on my back and have been asleep most of the day. Now, I will post again once 3 or 4 days have gone by because right now I still have some of the Toradol in me as well.

But for the most part I think it went well! I was scared to death of the pain...but there was NONE! Not yet anyway! :)

Hi Kathi!
Sorry I haven't been around or I would have replied to this before now. I'm glad your procedure went well for you and seemed to be pretty painless. That's good!

Since it's been a week let's have a progress report girl!! I hope you're still doing well! Did your doc say about how long it would take until you would notice anything from it, or would that vary? Fill us in please!
Hugs,
Jan :)

Hi Jan!

I am doing just fine after the Rhizo! :) I did have soreness the next day; more like a deep, achy bruised feeling. But, I am telling you...that's it! The neuropathic pain down my leg has stopped in particular my ankle which is what I was hoping for. God only knows if I had or have radiculopathy or small fiber pn. Sometimes I really wonder since this idiopathic PN almost didn't show up on the QSART.

Anyway, it has only been a week and they say to give it 3-4 weeks. But, so far so good. I am able to sit down for the first time in months without saying ouch! And am able to drive without pain. I can tell though, that the right side needs to be done since the facets are bad there also. It is just that the left was worse than the right. But now that I have been split in half so to speak, it is easy to tell that I have arthritic facets on the right.

Now, if I can just get my trapz, rhomboids, etc. to calm down I will be fine. This second cervical fusion has caused some spasms recently and it is difficult to remain on the computer for too long.

So, there you have it...doing just fine. And I will not hesitate to do it again; just wish I had done it sooner. :)

literature review
 

My PM who gave me a facet block at L5 late December wanted to do an RFA tomorrow. I spent the weekend online googling and reading whatever I could find.

I was surprised to find no long term studies at all, and only 3 studies that were at all reasonable. Most are very short term, maybe a month or two months. Nobody has studied or written on patients 5 years out. There are NO articles reporting side effects or bad outcome. I found all this unreasonable. I found guidelines for reimbursement by insurance companies, and some excluded people who had had prior spinal surgery.

There was one review article, and the abstract concluded that there was no evidence that Lumbar RFA is better than sham treatment. The email address of the authors was on the abstract on pubmed, so I sent him an email, and asked if he'd send the entire article, and, if he'd learned anything new since 2003 when he wrote the article.

HE CALLED ME. He said there is one more study, in Europe, done after his review, and it showed, again, that lumbar RFA does not work better than sham. He said there are definite risks, even though nobody has written on them. Some people ARE in worse pain when the nerve grows back. Many people are in pain again as early as 2 months, if they've had a "good" response. But specifically, he wanted me to know that the best evidence AGAINST RFA is with spinal surgery patients. There it absolutely never works.

He explained why. He said that the needle is put in to get the medial branch of a nerve, and that they can hit that nerve because they know pretty exactly how it travels. He said since you can't see it, you count on it being where it's supposed to be. But if you've had lumbar surgery, he said, the nerve is moved by retractors, and it's impossible to know exactly where it is. So doctors who say they are injecting the medial nerve in lumbar surgery patients are full of hot air. They have no idea where they are injecting.

So he thought it very important to call me and tell me not to get it--it's full of risk and no benefit.

I told him I'd gotten a facet block that worked; isn't that the predictor that they know it will work? And he asked me exactly how the block was done. I told him I got injected into both facets and the joint space. Aha, he says, that's what everybody's doing and saying it predicts RFA will work; there's a very specific protocol, and that''s not it.

He's an anesthesiologist in the pain group at Mayo.

(I then told him I have 6 loose screws in addition to the facet pain, and he suggested I talk to their spine department; five minutes later my phone rings again. He talked to the head of spine, who says nobody should be walking around with 6 loose screws and no plan. There's all sorts of tissue damage that could result. So they took the liberty of booking me for March 3.

The appointment is there; mine to cancel, he says. But the spine guy wasn't happy that I'm without a plan.)

Liza,

I am sorry to hear that.

But I did not have lumbar surgery of any kind. The facet injections proved where the pain generator was. I had the Rhizotomy and am doing just fine. I had also read up on all of this; the pros and cons. But I took the risk and would repeat it again in a heartbeat. Maybe I am like Bobbi in that I had good luck with it. Plus, my spinal PM is an excellent doctor so I felt safe with his opinions and recommendations. However, I have also read that sometimes they just don't work or increase pain. I have not had that happen yet. But like I said, I have not had lumbar surgery so what you have posted makes sense. :)

Kathi--
 

Please don't feel sorry--I feel I've had a couple of pieces of luck. First, it was good that the Mayo guy held me back, because the pain seemed a bit lighter. I'm also glad he was clear about what's been shown and not shown. Because in my case, I don't meet criteria for RFA having been shown to be useful, and it is a risk; there is a risk of worsening.

But in the last two days, my butt pain has eased. And oddly, it's been the left side that hurts, and has hurt for months, but now the right side is hurting. So while the facet block worked, it might not have worked as he thought, and injecting the nerve to the left might not have worked.

It's an odd thing, and I have no good explanation.

Had the rhizotomies only 5 weeks of relief headaches back
 

Well I already posted my story so I won't go into details here. But suffice it to say it worked for a little while, now I am on Gabapentin and my podiatrist knows a good rhuematologist and the neurologist and pain guy who think I am still one of their patients will be surprised when I send the letter asking for my test results and my treatment notes so I can bring them to the new doctor. As my 18 month old grand daughter would say, DONE, DONE, DONE.

My head pain is worse then ever and now I am having full blown migraines with the nausea and everything else. I can't even get meds into me because I know they will come right back up. So the "pain guy" who will not discuss the reason for the headaches until I see him in two weeks has prescribed Gabapentin for the "neuropathic pain". I didn't have this before the procedures. As debilitating as the headaches were and I didn't think they could be worse, oh boy, they are much, much worse. Now I have been out of work all week, the Gabapentin is working but the effects are dizziness, spatial relationship issues, hand numbness and leg numbness. Can't drive like this and typing is a chore. (excuse the bad typing and possible thought drifting).

When I asked him "Did the procedure fail, are the nerves regenerating, was this only parital lesioning" He said "You are asking too many questions we will discuss in a couple weeks at your appointment". Surprise I won't be there!
Well what do expect when I can't lift my head from my pillow?

Gabapentin/Neurontin works like a charm, you can feel it follow the track of pain right up the back of the neck, back of the head and up and around. It numbs as it goes. Hopefully the effects will level off. My Gp and yes I did see him, why they made an appointment for me immediately, hmmm, you need to come in, hmmm, pain guy couldn't care less. Well GP says give Neurontin a few more days and call if it does not level off we can try others. OH, a big OH, read the package insert on-line because I didn't get one with Neurontin. I take 500mg Naproxen 2 xs a day, not good. Naproxen, in animal studies, increased effects of Neurontin by 14% at doses much lower than human therapeutic doses so dose of each should be adjusted. They don't know what the effects will be at the usual or higher doses, hmmm. So I have switched to OTC Aleve 220 mg 2xs a day. Maybe still should drop the dose or discontinue the Naproxen (I don't think the Naproxen does anything anyway since I have widespread tendonits, don't know why, part of the arthritic process maybe.)

Doctors with the exception of my GP who is a Godsend do not like those of us who read. Now this is only my opinion based on my personal experience and I don't mean to insult doctors who appreciate patients who read and show an interest in their own health care and their diseases and disease processes. They are the best physicians if you are lucky enough to find one.
I really hope my new rheumatologist is of the appreciative doctors.

Thanks Jan,
I have not been online in a long time, just no time and meds are interferring with my life.
I took the Tramadol Saturday morning. I had taken 30mg of Elavil the night before. Oh boy, text book reaction; vomitting, brutal headache, tremor, profuse sweating, etc. Could literally not lift my head from the pillow for 1.5 days. I don't know, all I know is I need to unload 98 Tramadols (you can't flush any of the stuff anymore it's in the ground water, the highest concentration of drug found is estrodial, waste water plants can't filter all the drugs out, they aren't set up for that). I don't know why, I can take any and all opiods with only minor effects, upset stomach and the expected drowsiness that stuff. I have never had a reaction to anything like that. I thought I was dying and I could not pick up my head long enough to dial the phone. That's bad!

The Rhizotomies failed, I am in worse shape now due to brutal headaches, and neck pain (that I really didn't have before now my main complaint was headache). Now I have this crap going on in my neck, feels like something inside is twisting, I get this jumping nerve thing that drives me crazy and the headaches are full blown migraines with nausea and all the other manifestations of migraine, I did not have all that before.

Now pain guy says "neuropathic pain" put me on Gabapentin, which works wonderfully but I am having the effects from the Gabapentin, dizziness, spatial relation issues, numbness, and so on. He says we will talk about it at the next visit in two weeks. Well surprise!! I found a rheumatologist highly recommended by my podiatrist (ankle pain, no bone problem yet he thinks it's OA starting in the soft tissue). I am no longer their patient. And they will find out when I cancel my followups. I will write them for my test results (EMG/NCV) and treatment records that I want for the rheumatologist. And I will, if needed, have the new doctor refer me to real pain management if that's where I need to be.

My RF Treatment
 

Hi All,

I'm new to the forum but I had RF on my neck (c3-c5), Monday 2/18/08. So far, I haven't seen any improvement but I understand it takes time and it's been only 4 days. I hope that in a couple of weeks th pain will subside and I will see results.

My background: I'm a 52 y/o male and I have Degenerated Disk Disease. My past treatments: I have had a Micro Laminectomy and a Cage Fusion on my lumbar (L5-S1). these were done after many facet join and Epidural injections. and my lower back is still crap. Then, about 2 years ago, my neck started giving me trouble. My MRI shows that C3-C6 as having problems with C3/C4 being the worst. I have had several facet join and Epidural injections with NO help. The RF is basically my last stop before another major surgery that, in the past, hasn't helped at all.

I guess I'm ranting a bit, but I'm hoping that someone here has had similar experiences and can perhaps offer some advice.

Thanks

Hello out there! I am not sure if this is even the correct place to respond (as the previous posts are rather old) but I am scheduled for the diagnostic test that proceeds the RF..... but when talking to my worker's comp nurse today she recommended that I do some research before agree to either procedure. She knows that I tend to be very proactive about my treatment.

I am very glad she had me take a look around, and I am left feeling pretty hesitant now. Did anyone out there end up with positive long term results??