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Facet Rhizotomy also called RFA or Radio Frequency Ablation

JunebugJJunebug Posts: 71
edited 09/08/2013 - 5:21 PM in Pain Management
I got a Lumbar Facet Rhizotomy done yesterday It It really helped me reading Kathyy's journal for this procedure. I am going to keep track of the pain and let you know if it helps or not. I hope this helps you.

Yesterday I got facet radio frequency ablation, also called Rhizotomy done.
It was on L3-L4, L4-L5, and L5-S1, both left and right sides of my back.

Background: I have had steroid injections many times before over the past three years. Some have worked well, some have only worked for a few days or not at all. The best steroid injections gave me great pain relief for two months.

How the procedure is done: I was given some fentanyl in an IV to help with the pain. The doctor probed with a needle to see if the medial branch nerve twitched or thumped, and to check that she had not hit the sciatic nerve. It was not nearly as painful as getting facet injections without sedation!
Once this was done in all six sites, I was sedated and woke up in the recovery room.

Day One

4:30 - Went home pain free
6:00 - Still no pain except on the top right side. I wonder if one level up was missed?
7:00 - Took two Aleve because I usually do every day. Didn't really need it!
Used ice pack because I was told to, but didn't feel sore at all.

Day 2

3/25/11
6:00 - Slept well last night. I Feel really good. No real pain yet. Pain is at Level 2 only on the very top right side, but that side was where most of my pain was from before. So far so good!

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134

Comments

  • 4 pm - Feeling very tired. Headaches all day. Was able to go to school. My usual back pain is back, but no worse than before the rhizotomy

    Junebug
  • Day 3 - I felt great all day. Surprised that I had very little pain. I didn't even take Aleve today.
  • Day 4 after my rhizotomy I am feeling pain. It hurts to sit and I have a headache. I took Aleve this morning but I am still in pain. Used my Interferential Unit (Like a TENS machine)
  • Day 4 after my rhizotomy I am feeling pain. It hurts to sit and I have a headache. I took Aleve this morning but I am still in pain. Used my Interferential Unit (Like a TENS machine)
  • Day 5 - I was able to walk today without pain. I walked about a mile. I am not pain free but the pain is not bad at all.
  • It's been a week now. I still have pain. A bit disappointed, expected to be pain free. It is at least as bad as before the procedure, probably a bit worse.
  • Day 12

    I am wondering if the RFA worked. The doctors notes said there could 1 - 3 weeks of pain from the procedure. It feels more like the same pain as BEFORE the procedure. Stiff, can't bend back very far. Pain level is about a 6.

    I notice that when I first wake up I have less pain. As I sit and compress my spine by walking and sitting, the pain starts getting worse. This was also true before RFA.

  • Day 13

    For the first time, I felt pretty pain-free all morning. I did not have to take pain medicine until the afternoon. When I wake in the morning I feel almost pain-free. It gets worse as the day moves on. I think it may be working. Fingers crossed!
  • It's late at night, and my back is really hurting. Still, I have not had Ultram all day. The pain is a bit better or the same as before the procedure. Have not had to use the interferential unit (like a TENS) all day.
  • had an rfa done 3 days ago and my pain has increased significantly past 24 hrs, Certainly am concerned about rfa failure.
  • Gymjack, the same thing happened to me. I phoned the doctor. She said it can take 3 weeks to feel better. It has been 2 weeks (16 days) and I am still hurting. I have an appointment in a week, fingers crossed that it starts feeling better.
  • It's been 18 days, or 2 1/2 weeks. I am still having pain, so I am stopping exercise. Had been doing exercise DVDs and physical therapy exercises, but everything seems to make it worse.

    Today I am trying to go without painkillers to see how long I can make it. I have been using the Interferential Unit twice a day for 20 minutes.

    I really hope I am better soon. I have my first follow up appointment with the doctor in 4 days.
  • Day 20
    Just doing stretches now for exercise, and walking a bit. Today I went without painkillers all day, but it was tough. Pain level is around a "5".
  • Day 21
    Three weeks now. I am in a lot of pain. Used the Interferential unit twice today. Aleve doesn’t work. Ultram doesn’t help. Pain Level 6.
    I see the doctor tomorrow for follow up.
  • I saw the doctor today for a follow up. She was not happy that I still have Pain Level 6.

    She said we should give it some more time before we bring out the big guns. She talked about some kind of pain killer patch that could make me sleepy like vicodin. No thanks!

    - She gave me Lidoderm lidocaine patches to try. I tried one but it had no effect.

    - She gave me Lyrica, 50 mg. twice a day, just to take for 2 weeks. I was okay with that.

    - She gave me a Medrol Dosepak (Prednisone) to take for 6 days.

    I have had great luck with the prednisone tablets in the past. I hate Lyrica, it makes me sleepy and forgetful! But I am okay with taking it for 2 weeks. I follow up again with her in 2 weeks.
  • Wow! After one day on the methylprednisone, I am 80% pain free!
  • The prednisone only worked for 2 days. I am also taking Lyrica, which is not doing anything. The pain isn't horrible, just not any better than before the procedure :(
  • I'm guessing it didn't work, or it would have worked by now. It is over 4 weeks. I am still in pain. Not awful, but a 5 or 6. About the same as before the procedure.
  • 5 weeks later I am starting to feel better!
  • It has been 6 weeks since my RFA. Today for the very first time, I am pain-free. I didn't even have to take Aleve at all today, or use my interferential (TENS) machine.

    Two days aho I did get injections in the greater trochanter bursitis (upper thigh), both sides. I had those a year ago, and they really helped. I wonder if that could help back pain somehow, because I walk better?

    I am supposed to get SI injections next week, and also start physical therapy. I may just skip both!
  • The outcome of my RFA? It didn't work for me. It has been about 10 weeks. I have still been in pain.

    I am in physical therapy now for about 2 weeks, and it is helping. I am strengthening my core muscles (lower abs).

    My doctor said that there is usually a very high success rate with the RFA. I just hope to be pain free enough to take a cross-country train trip this summer! I plan on going up from the Midwest to the Pacific Northwest, then down the coast to California.

    Junebug
  • The outcome of my RFA? It didn't work for me. It has been about 10 weeks. I have still been in pain.

    I am in physical therapy now for about 2 weeks, and it is helping. I am strengthening my core muscles (lower abs).

    My doctor said that there is usually a very high success rate with the RFA. I just hope to be pain free enough to take a cross-country train trip this summer! I plan on going up from the Midwest to the Pacific Northwest, then down the coast to California.

    Junebug
  • I just had my RFA on my left side, have to go back next week for the right side and I'm absolutely TERRIFIED! I had a terrible time during the procedure, Doc said she had to give me much more Fentanyl than most patients due to my pain level during the procedure. Have been in some serious pain since with pain starting out about a 2 in the morning and as soon I get out of bed, it rapidly rises...by the time I get home from work I'm in tears!
    Called the Doc on Thursday and she prescribed a low dose of Lyrica 2X daily. Pain is a tiny bit better but I am also taking Vicodin every 4 hours and icing.
    So sorry your RFA didn't work for you...keeping my fingers crossed that you find relief for your pain!!!
  • Junebug, so sorry to hear that the procedure did not work for you. I just had it done to the sacrum and L5 five days ago for the third time since 2007. I do tend to get relief from it but not 100%. I've not been off pain meds this entire time and take Lyrica 200 mg daily and Percocet 5 mg 3 times daily. I'm sorry to hear that for you it did nothing. I have no idea what's in store for me in the long haul either and this is a bit scary. I hope the PT helps you and I have also found this helpful. I also started pilates and have been trying to strengthen my core muscles. Best wishes to you and thanks for sharing your story with all of us.

    Lisa
  • Hi Gypsy,
    I had twilight sleep for the RFA. The doctor only woke me to see if she was in the right spot for the nerve.

    Lyrica didn't help me one bit. Have you tried an interferential current machine? It is like a TENS but it goes much deeper. I used it a lot when I was in severe pain like you are.

    RIght now I am doing pretty well! 2 Aleve twice a day is helping me. That along with the physical therapy.

    The doctor told me no more RFA, no more steroid injections until at least October! She did say that sometimes the facet injections stop working, and then the RFA doesn't work either, but I still have hope.

    Please let us know what happens after your second injection.
    Junebug
  • Hi Gypsy,
    I had twilight sleep for the RFA. The doctor only woke me to see if she was in the right spot for the nerve.

    Lyrica didn't help me one bit. Have you tried an interferential current machine? It is like a TENS but it goes much deeper. I used it a lot when I was in severe pain like you are.

    RIght now I am doing pretty well! 2 Aleve twice a day is helping me. That along with the physical therapy.

    The doctor told me no more RFA, no more steroid injections until at least October! She did say that sometimes the facet injections stop working, and then the RFA doesn't work either, but I still have hope.

    Please let us know what happens after your second injection.
    Junebug
  • Junebug, was that the versed? I did have that but I do remember everything, hoping I won't on Friday. I have a tens unit but never tried the other thing. Right now, my pain level is a consistent 3-4, no vicodin today! YEAH!
    So sorry you're still in pain!!! It just seems to consume our life and I sure hope you are able to find some relief very soon!
    I'll keep you posted on my procedure on Friday...very scared after my left side but hoping this can bring me "some" relief!
  • Gypsy, I think a 3 to 4 is not bad! Maybe it worked for you. I think I did have Versed. I was out like a light! If you are interested in the Interferential, it works. The TENS does not help me. I got mine from Zynex Medical, and my insurance covered the cost. Also the replacement pads and batteries. Zynex accepts what the insurance pays and I don't have to pay the co-pay!

    Good luck!!
    Junebug
  • Thanks for the info, I will keep that in mind and ask my PM Doc. The TENS use to work but hasn't in the last couple years for me.
    Not sure if the Lyrica is helping or not, but I do get very tired after taking it. In the evening isn't too bad but before work...well, makes for a long morning!
    Gypsy
  • I am scheduled for another try on 11/3. The first RFA rhizotomy didn't work at all, wish me luck!
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