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RFA Scheduled Dec 20

EMS GuyEEMS Guy Posts: 915
edited 06/11/2012 - 8:58 AM in Pain Management
Hi all,

I am scheduled for RFA Dec 20th. The Facet Joint Injections have helped so they say I'm a candidate for it. I am having the procedure done in the doctors office. They are prescribing me valium to take right before the procedure.

I have to say all the talk from different strings on this board has me a little worried about the pain level during the procedure. Valium is pretty mild to me. I had it in the hospital after my ALIF and it really didn't do squat for me except screw with my sleep. I've been reading of people needing Fentenyl during the procedure. That stuff is wicked powerful. Yet, my doc is only allowing valium (since he is doing it in his office).

I was given the option to having it done in the hospital, but I didn't want to do that due to how much pre-op and post-op time is required.

Just how painful is this procedure to have done???


Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2


  • I have actually had more than one rhizotomy; yes facet blocks working are an indicator of facet block success. IMHO, rhizotomies are pretty painful - not like "surgery" painful but a whole lot more painful than facet blocks. I would really question a pain doc not using fentanyl for this...they are quite literally going to burn your nerves after all! If I were you I would do hospital route for the IV meds.
  • I take it that he has all the equipment necessary set up in his office? If its not being done with an xray assist I would not get it done. I had one a couple years back and took only adavan for it, and yes it was painful. The only thing about a RFA is that it is very important for you to give the doctor feedback on how it feels when they are probing around. The outcome of the procedure depends on them getting the right spot.

    As far as the pain, I was able to cope with it and I felt that my clear feedback was more important than having a pain free time. It took three weeks or so after the procedure, but it did help my pain a considerable amount. Good luck to you and keep us posted.
  • Pain is relative, it depends on the person. I've had a total of 5 - 4 cervical, 1 SI and am about to have the other SI joint done next week. I have never had anything for any of them except for local anesthesia. Oh, except for the first one, he did administer versed, which doesn't work on me, I guess he had to see for himself that it doesn't, as I did tell him, lol, he hasn't bothered using it since. Yes, they are painful, but not the worst pain I've ever experienced, and the pain only lasts for a few seconds, as he's testing the individual nerve, it's not constant, the whole time. If you're into meditation and breathing exercises, I find that helps. I actually fell asleep once and woke myself up snoring, he and the tech had a good chuckle over that, he said that was a definite first, for someone who doesn't take anything beforehand.

    You should feel a difference immediately, but don't worry if you don't, it might take a while. With my neck I never felt it immediately but I did with my SI joint. You might also feel some pain/discomfort afterwards for a couple of days once the local (or steroid if he uses it) wears out. Ice will help. Or, whatever works for you. Also your tens if you have one.

    As neednewback said, you do need to be able to communicate with the doc during the procedure, which is why they need you to be alert. My pm does the RFA right in his office under flouroscopy (an xray type machine), in a room that is specially set up for procedures. My results have been excellent, cervical, 3 out of 4, all lasted about 5-6 months, one of them I ended up with a bad case of neuralgia. He said that could have been because the frequency was set too high. I just had my SI done in October, and the result from that was amazing, I can't even tell you the relief I've had. I can't wait to get the other side done next week. Actually, the last cervical, and my SI, were done using pulse wave instead of radio frequency, which was a lot less painful, and little to no post-pain/discomfort. I wish you luck, hope you have excellent results and as good relief as I've had with them!
    APROUD CANADIANveteranButNOTa doctor, my thoughts are my own
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