Next step after injections have worn off

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Cath111's picture
Last seen: 3 weeks 1 day ago
Title: Member
Joined: 09/02/2008 - 10:06am
Next step after injections have worn off

Hi there. I had the appointment with my surgeon's PA yesterday as a followup after my ESI and Facet Joint injections wore off. I'm having significant lower back pain and what feels like sciatic pain down the back of both of my legs, but just down to my knees. I also have pins and needles in both legs, but most noticably in my right leg.

The PA said that because the injections worked for five weeks that I'm a perfect candidate for RFA (radiofrequency ablation, aka nerve burn). She also thinks that the pain in the back of my legs is referred pain from my facet joint problems and thinks it will also be fixed through the RFA. The pins and needles are most likely from the diffuse disc bulge touching nerves, but it's not enough of a concern to consider any treatment now.

The first course of action will be a medial branch nerve block. If I feel relief from that for six hours or so, then I'll have to go back another day and get the RFA on those same nerves. Hopefully the RFA procedure will fix the pain for at least six months, hopefully more.

On a side note, the pain I'm having in my neck is due to movement at C6/7 that hasn't completely fused (it's the most difficult level to fuse) and she wants to revisit that issue in December to see if I'll need posterior surgery to secure that level. We'll also discuss the RFA at that time unless I need to see her before then.

She also changed my medication from Hydrocodone every 6 hours to Norco every 4-6 hours to lessen the amount of acetaminophen I'm taking because I've been having some stomach cramps. This will also lessen the possibility of having liver issues.

So, that's my update. I'm looking forward to having the RFA done because I'd sure like to not walk around with this back pain every day. I really love my doctors and feel very lucky to have found them.


Last seen: 3 months 3 weeks ago
Title: Member
Joined: 01/02/2009 - 1:25pm
Hi Cath

It sounds like you had a pretty good doctor visit. Do you already have the appointment for the nerve block?
I really hope the RFA takes care of your pain. I also hope that C6/7 fuses so you don't have to have another surgery.
Hope the Norco works better for you. I take tramadol and I take a lot of tylenol too. I am beginning to worry about taking it so much. My doctor says I need to quit the tramadol because of liver damage. We try to help one problem and create more don't we?
Take care Cath.


TTLC's picture
Last seen: 1 year 9 months ago
Title: Member
Joined: 04/05/2009 - 12:28pm

Hi Cath,

I just noticed that my reply to you a few days ago, didn't take.

Darn it. (I'm sure it was user error, but I should have checked it).

I need to go to an appointment, so I will rewrite my reply to this thread when I get home.

Hope you're doing okay,


dilauro's picture
Last seen: 9 hours 22 min ago
Title: Moderator
Joined: 06/16/2008 - 9:41pm
Cath, this may not always work

But when any relief from ESI wear off, I like to have trigger points done. In fact today, I had 4 trigger points down on the left side of my neck.
Too much outdoor work left a few trigger points jumping and bouncing. My Deep Tissue guy worked on them, helped them, but when I went for my monthly check up with my Pain Management doctor, she felt my neck and could feel all the knots. She fire away with those Lidocaine shots. That gives me some time to calm things down....

And at least with trigger points, there really isnt any limit. (well maybe about co-pays)

Ron DiLauro Spine-Health System Moderator
I am not a medical professional. I comment on personal experiences.

charry's picture
Last seen: 2 months 2 weeks ago
Title: Member
Joined: 09/06/2008 - 12:39am
Hi Cath

The RFA sounds very promising if the nerve block works. I was hoping to get that procedure after having the facet joint injections only offered temporary relief but now my MRI mentioned nothing about facet joint arthropy that I had before. I hope that the PM clinic I go to at the hospital can offer me some relief. I hope you fuse completely also so you won't require any surgery. I'm happy for you that you found great Drs. to help you. take care. Charry

DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN