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Radiofrequency nerve ablation

georgiagirlggeorgiagirl Posts: 12
edited 04/20/2014 - 8:20 AM in Pain Management
Finally saw my NS today and he wants me to have radiofrequency nerve ablations done on two levels of facet joints (above and below my fusion). I had it done once before, on one level, about two years ago. I said at that time I would never have it done again because the pain afterwards was so intense and I'm not sure it helped at all. Well, given that I want to avoid more surgery at all cost, it looks like I'm going to have to do this again. I'm scared.

Can anyone else give me their experience with this procedure? Did anyone have an increase in their pain immediately afterward? If so, how long did it last? Has anyone had any good pain relief from a RF? Again, if so, how long did it help?

Thank you!


  • Hi georgiagirl,

    My RFA was not very effective at all, but I did it on the advice of my physician. I'm surprised you're going to do it again if it was not effective for you the first time. Personally, I wouldn't do mine again.

    There also may be issues with your insurance giving authorization for a new RFA procedure if there isn't any evidence that the first one relieved your pain. I wouldn't do it again, but this is your own journey, and if your doc thinks this is worth a second try, and you are up for it, I guess your decision is made.

    I'd definitely make sure your insurance (if you're in the US that is) approves it beforehand.
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
  • Good luck!!!!
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
  • Cheryl, if it didn't work the first time and it hurt you that bad, why are you doing it again? I'm having my RFA done Tuesday and I hope it works, I'm not worried about the actual procedure, more concerned about the pain, I read most people have afterwards.

    Cheryl, if you do have it done, I wish you all the luck in the world & I hope it works for you this time. :-)
  • Thank you, Sarah and Taren for your thoughts. I am definitely going over try pros and cons of going forward with the RFA again. And I will for sure confirm insurance covers it - thanks for reminding me. :) I guess I feel pressured to do this because I'm on disability from work and I know my husband and family are anxious for me to take some action. I just think I'd like to try PT for now while I wait for my CT and X-rays to be done and reviewed by my NS. Problem is that I can't get in to see him for a month and I think everyone will want me to do more than just PT while waiting to see him again.

    I'll let you know what I decide. Thanks again for the feedback!

  • MSGMSG Posts: 296
    edited 04/20/2014 - 8:16 PM
    The pain of this procedure was much worse than the epidurals, & the "recovery" period was longer. I don't think it helped all that much. The epidurals did, but only for a short time. None of these procedures are without risk. Would I do it again? If I thought it would keep me from having surgery, yes. I absolutely do not want surgery, & even if I did I am not a candidate.

    Good luck with whatever you decide, & we will support you either way.
    We can't always control the cards we are dealt in life, but we can control how we play the hand
  • I suffer from occipital neuralgia (burning pain from angry nerves on the back of my skull). I have an excellent pain management doctor. Both times, I had immediate relief from the lidocaine they use. I got pretty significant pain reduction for about 5 months each time. During the last procedure, however, the back of my neck had surface burning for several weeks, and I presume this is from radiation burns from the x-Ray machine.

    Good luck and keep us posted!
    April 2011 C1-C2 Fusion (Brooks wiring)
    January 2012 C1-C2 Revision Fusion (Harms Technique)
    2010 - current: Trigger Point Injections, Epidural Injections, Bilateral C2-C3 Radiofrequency Ablations
  • I had 3 nerves ablated 6 weeks ago C-2 to C-4 including the 3rd occipital nerve on left side of my cervical spine since the steroid injections worked prior to it for those levels , but just not for long enough ( only a month) and I have very adverse reactions to steroids ( they lay me up in bed , severe pain, rash and insomnia plus sky rocketing glucose levels that produce painful neuropathy in hands and feet ) , so I really had a lot of hope riding on RFA's working for me so that I can work again, but so far, that's not the case and I am at my wits end with extreme pain and disappointment 6 weeks later with searing pain from the back of my head and neck all the way down BOTH of my shoulders , into shoulder blade area , and down arms into guess what ? My hands ! I had not had problems like this for months prior to the RFA and had not had the issues on the right side before . How can an RFA down at these high levels of my cervical spine cause such brutal pain in areas supposedly " corresponding levels lower down "to the shoulders, upper back , into arms and hands like this ? The RFA procedure itself seemed to go well enough and afterwards while the lidocaine was in effect things seemed as if they were going to be fine For 5 days afterwards ( except the first day and a half with the numbing agent) the pain was so bad I could not sleep, eat or keep down liquids as I was in so much excruciating pain and was put on even more meds to help control the dry heave vomiting. I declined the Percocets offered though as I am already on lots of meds, including Norco and did not want to take that " step up"in narcotic pain relievers even though the Norcos did not even remotely cut through the pain. Was prescribed Fioricets to alleviate the worst migraines I have had in my life ( I have suffered for many years with migraines until oddly enough a year ago when I was started on Norcos after CT surgery on both hands , but was able to manage them fine with Maxalt and this was not why I got the RFA procedure done. It was for facet joint syndrome causing problems not only on the back of my head and neck, but shoulders and back down into my hands that supposedly the steroid injections helped with on the higher levels C-2 to C-4 as the ones done lower down on C-4 to C-6 proved to do almost nothing . The doctor said that perhaps the medicine for the upper nerves calmed the lower ones down too . Ok, well why am I in so much referred pain from the nerves now in places that do not correspond to the RFA , on both sides, as well as worse ? Still have burning on the back of my skull but I can manage that , just not the burning and shooting pain into my shoulder blades and down into my hands. I feel that I was better off before in some ways ( better neck mobility and can sit longer, no headaches ) , but worse off in others that are really bad. So far it seems in the " cost benefit analysis " here that I traded one problem in for others just as painful, if not more so. Has this happened to anyone else with an upper cervical RFA ? If so, did the pain finally subside ? How long did it take ? I am only in my 40's , I am a mother, and have to be able to work full time out of the home to help support my family. Very upsetting to myself and family with the continuing, seemingly unsolvable problems with my neck and hands as well as being diagnosed with Fibromyalgia , Cervical Facet Joint Syndrome,Osteoarthritis in neck/DDD , plus Carpal Tunnel ( which I had 2 supposedly successful surgeries for ? . This has have been going on now for almost 2 years . I have lost so much and cannot lose anymore I don't want to lose my marriage or my family over this. I am a mess with all this chronic pain and so many medications . At my wits end. Any advice from those having the same/similar from an RFA done on the cervical nerves ? Please advise. I'd really appreciate it ! Hope to hear some encouraging news, but if the truth is all negative and nothing real positive, than I am prepared to accept that and move on. Thanks !
  • I had RFA done on both sides of my lower back. 3 levels each time. I recovered at home with only Tylenol and Motrin both times. Yes there was some pain and discomfort but nothing I couldn't handle by any means. Good luck!!!
    Kristie H
  • ljhlljh Posts: 10
    edited 04/20/2015 - 4:14 AM
    I had RF on my cervical spine with great success. Yes, there was a lot of pain initially, but the improvement lasted for 2 years, with one "tune up" as the doctor called. it. I will do it again, when necessary.

    On the other hand, I had it done on my lumbar spine, above my fused spine area, and it only helped a little. A lot depends on the placement of the devise. If the doctor gets exactly the right spot, then it can be very successful.
  • RF Ablation is a procedure that intentionally injures nerves to prevent pain signals from being sent to and processed by the brain. It is a minimally invasive surgical procedure reserved for those with chronic pain who have not found relief from more conservative treatment methods. I do believe that this procedure is helpful to some degree for around 70% of those who receive it. That being said though, this treatment is NOT a permanent solution. It is what I like to label, a "Band-Aid fix." Over time (1-2 years), your nerves will heal and that same pain WILL return. It is important to remember that this procedure is a treatment that addresses the symptom of pain, not the initial causes of that same pain. In some instances, this procedure CAN make your pain level much worse (if done incorrectly and the targeted nerve is damaged) and it 100% WILL make your level of pain worse before making it any better (1-2 months before experiencing any relief). Others do NOT EVER see any improvement. My advice is for you to research the pros and cons of this procedure as there are many. Make an educated decision based on those pros and cons. Be thorough as this is YOUR life. Knowledge is power.

    Wishing you all the best.

    Realize that FEAR is our worst enemy. Get up & get out in that stormy weather of the real world & kick fear in the teeth. Stare at it dead in the eyes & walk right through it into the storm; because once you're wet, you won’t fear the rain anymore
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