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RFA versus SI joint block. Have you had both?

I was in my pain management doc's office today, talking about how I'm going to deal with my SI joint pain if I get my L5/S1 fusion. I've had one SI joint block, and it worked like magic. However, I am not wild about the thought of having to keep blitzing my body with cortisone. Doc mentioned RFAs.

Anyone here have experience with both? If so, which worked better? Potential side effects?

Any input is helpful thanks!


  • JoydancerJJoydancer Posts: 463
    edited 08/17/2012 - 10:50 PM
    From your question, you were wondering about dealing with SI joint pain, if you get Lumbar fusion...

    I have had RFA's for ongoing DDD and progressive pain, chronic episodes for disc bulges on three levels, they have been marvelous for keeping me from doing surgery. DDD over 30 yrs and Im 63 my priorities are all upper spine C-Spine/T-Spine but discs have gone to advanced from moderate, and for past 6 years I have had RFA's that last me 2-3 yrs (mva caused me to have them done closer together post-mva 1-2 yrs)

    I would imagine if you were wanting the RFA's for adjoining levels non-fused pain it may be done. If it's done on the fused level, don't know that one.

    Done by experienced anethes/pain specialist (my criteria going to someone who is high-level of exper. # years doing and prime specialty - full-time) I had done in previous town I lived to start, didn't help, but then after my move got to a prime Spine Center in Atlanta, GA & he did RFA's total relief ! It does make a difference experience he was 15 yrs in it and prime practice-full time with it & overseen by Chief of Spine.

    I had no side effects with first two injections - 3 yrs apart but now that three levels are more advanced and needing right & left side on each level, I'm sore and take R & R 2-3 days, each day improves, no reactions or problems though.

    There's no comparison truly to what RFA potentially can give you, level of relief & duration, over cortisone !
  • I have had RFA's also, years ago when it was called a rhyzotomy. Again it is supposed to be much better and less painful than the old days!! The RFA would be something to do before surgery; hoping it would eliminate or postpone pain. For most people it offers relief for much longer than cortisone. For me it didn't work. I know it works well for some people.

    Again, everything is worth trying before you decide on fusion. But sometimes a fusion is the only answer to pain relief.

    Good luck.

    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
  • MarniMMarni Posts: 45
    edited 08/31/2012 - 3:06 PM
    I had 3 fusions at L5/S1, the last one was about 12 years ago. I've been suffering with chronic pain ever since. I now have a number of issues atveach level including severe arthritic deterioration of both SI joints and left L4 nerve root impingement.

    I had my first RFA on my right SI joint in december 2011. It was painful during the procedure but not horrible ( my doc did 5 levels of lesions). It took about 6 days for me to recover and about 2 weeks to really feel the effects. It worked really well. My pain on that side has substantially improved. I also had 2 of my graft sites on that side and had such hypersensitivity to any touch or manual palpation. Now, after the rFA, whole area including graft site are basically numb. Prior to this, I had had numerous SI blocks with and without success. I'm very happy with the results.

    This pastbmarch I had RFA donebon my left SI joint. Totally different experience. Wont get ito te gory details, but Basically didn't work. Clearly the SI joint was my main pain source on the left side.

    Hope this helps. Good luck, Marni
  • Hate typing on my iPad :-(

    Meant to say the clearly SI joint was not main pain source on the left side.
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