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Value of RFA/Rhizotomy when not in active pain?

SteveCSSteveC Posts: 63
edited 06/11/2012 - 8:59 AM in Pain Management
I had a recent flare up which got me on a prednisone dose pack. The PM's PA said a rhizotomy was probably called for. I have already had one on the right side and am unsure if it really helped or not. This one would be on the left.

The issue right now is the pain being quite manageable (contast 3 peaking to a 4 - during the flare up I was at a 7). What are your Spiney's' thoughts on having this procedcure done when not in actiuve pain?

Thank you!


  • I had an RFA done, and it really did not do anything for my pain, so for me it was a waste of time and money. I know of people that have got good results from the procedure, but not me. If you are not in active pain, in the other hand.. why would you want to put your body through such an invasive procedure? I don't know, but I wouldn't do it.

    Take care,
  • I personally don't view a rhizotomy as any more invasive than an epidural. The thing is the severe pain is not constant - so perhaps that is the answer I was looking for...save the rhizotomy for constant pain.
  • Has your doctor mentioned a diagnostic first? Even though he has been doing the RFAs for a few years to me now, my doctor always starts with a diagnostic short-term procedure. It's just a shot of anesthesia to the nerve. Even if you're in a 3 or 4 pain, you should still know if it is effective or not. I've gone in with a 1 (due to fentanyl patch) and could still tell. Once your doc knows if they're in the right spot, the RFA should be a 'no brainer'. If you have no pain relief from the diagnostic, and RFA won't help. If you get relief from the diagnostic, the RFA is (at least) in the right spot. Whether you get relief from it or not is, like any treatment, up to your body.

    I get a tremendous amount (85-95% if not 100%) of relief from the RFA procedure. It has lasted about 9 months for me in the past. My doctor office bought a new machine that is supposed to do a "more thorough" burn (much more painful too!) but it did give me longer relief in the SI
  • I've had nerve blocks before as a diagnostic and I thought that was a more uncomfortable procedure than the rhizotomy! During the rhiz. procedure I recall he placed the various conductors and asked me when I felt throbbing so he cound confirm placement of the probes.

    Right now I am back at physical therapy in preference to another rhiz. The PT seems to have a good handle on my situation and we are trying a combination of traction, and stretching with a minor amount of core strength (I work out a lot, so don't need to have a PT tell me how to do pure strength exercises). So far, so good :)
  • Yeah, the nerve blocks for diagnosing and locating the pain do kind of suck. You only get a short-term relief (a few hours! LOL) and now you're sore for a bit from the injection too. If you're lucky, your doc might squeeze some steroid in there too. That helps lessen the pain, in my case, for the 2-weeks I wait for the RFA to be scheduled.

    Glad to hear you're in PT and it works so well. I tried PT a few times, but only had 1 therapist that was effective. She put her hands on me. I was so surprised by this simple difference between her and other therapists I had seen. None of the others had worked on posture, actually pushing my hips back to the proper position. This gave my muscles the memory of where they're supposed to be to support my spine. What a massive difference.
  • Good posture and remembering what good posture is, is really important. My first experiences with PT were pathetic...ride the bike do the weights. One time I was chastised for doing lat pull downs with the entire stack as "[you] aren't supposed to be working out!" You have to listen to me...I am not weak in a gross sense, you have to help me out with the smaller parts which add strength to the whole.

    The PT Group I am with now definitely understands the issues of spine sufferers and they actually noticed that my pelvic bones were not "level" so they did some chiropractic style manipulation and the relief was near immediate. Just in case you are interested. you lay on your side, hips stacked, legs and knees together at 90 degrees (as if you are sitting down), with your legs off the table/bed. Have someone push gently on your knees and you resist. Hold for a while, relax and then drop your feet down about 30 degrees and repeat, then do 60 degrees.

    The other great fix was applying firm, significant pressure to tight and spasming muscles. The pressure cuts off the blood flow to a degree, and without the blood flow, the muscle loses the energy source to keep contracting. Amazing!
  • That's about the same experiences I had (minus the scolding). "Do this exercise, now do this, pay on your way out". I was blindsided by this one therapist I had, she was amazing. She just started grabbing my pelvis and moving me around, but I quickly realized how important that was. I don't continue the exercises like I should, but try to keep the posture she taught me. It's such a basic thing, I guess that's why the other therapists I went to didn't even cover it. Unfortunately, it's probably the most important since I haven't herniated any more discs since!
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