SI/L5 Nerve burn

SI/L5 Nerve burn

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SteveC
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SI/L5 Nerve burn

I have had an L5-S1 disc/lami on the left side, worked really well. I also have a small disc bulge on the R at the same level which was not treated. I recently had a series of steroid shots on my L SI joint which worked well.

Then I did something around the house wrong and now I have problems on the R side. I thought it was my spine, but the doc said he thought it was the R SI joint. I got a steroid shot and things seemed to be going OK.

Fast forward to Xmas day and I was kneeling down and then my back started to give me problems. Weakness, pain, trouble walking etc., Today I slipped slightly and stepped heavily on my right leg. Now my back is a mess. Called my PM Doc and he said I needed a bilateral nerve burn. I'm on Tramadol now.

I have several concerns. The first is the potential for loss of feeling. This is supposed to stop/reduce pain, but it doesn't treat the underlying condition. Nasty though the pain is, it is there for a reason, I am concerned the pain band aid, could ultimately cause more problems as the mechanical problem(s) are not being treated.

Anyone have any experience with this type of treatment? I trust my doc totaly, but it doesn't stop me being concerned!
Thanks!

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SteveC
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Just had it done

Some of you might know this already, but the nerve burn = RFA = Rhizotomy. I prefer the RFA as it stands for radio frequency ablation and since I am a scientist...

A quick spiel on why he "advised" this procedure and then a couple of paragraphs on what it was like. He said the discomfort which my chiropracter said was the L5 disc space is more likely *not* due to the bulge, as disc bulges tend to radiate the problems axially ie. down the leg and my legs are fine. (When I had my op, I had leg drop, so that was a clear reason for surgery). He also believes this could be my spinal joints due to thinning discs. I need to follow up with him more about this at my next follow up.

Clearly I have some SI issues which did respond well to local steroids. But there is a limit to steroid injections. RFA should numb the nerves enough to stop a feedback cycle causing more discomfort, muscle tightness, pain etc etc., This should give my body a few months to get itself under control and hopefully balance itself out.

Anyway, the procedure was no worse than any other procedure. Multiple shots of local anaesthetic with the usual feelings of pressure and sometimes mild burn. This was followed by some placement tests to ensure they didn't cook the nerve too much. This entailed them increasing the signal to the 4 probes and me telling them when I felt pressure or tingles. The Doc said he wanted me to tell him early, it wasn't an endurance test. About 2 minutes after the position testing we were done and I didn't even realise! The X-ray image was soo cool...4 lines clearly pointing towards the nerve root exits.

Afterwards they took me in a wheel chair to the recovery area where it took about 45 mins for enough of the local to wear off for me to walk carefuly. About 4h later now and I am fine enough. Some discomfortand at the injection site, but honestly a flu shot hurts worse, except they aren't usually where I want to sit down! A touch of weakness due to the locals, but that will be gone once everything wears off.

lilac100
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I was just looking for

I was just looking for information myself. I haven't had the procedure, my PM scheduled me for a shot to test to see if it would fix my pain before he goes and just burns nerves that aren't causing the pain. I'm very nervous as I would be able to take my painkillers or 24 hours before the test and man I don't know if I'll be able to do it. I hope someone comes and gives info because I'm just confused.

SteveC
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Hi Lilac, If I understand

Hi Lilac,

If I understand you correctly you are having a fairly simple nerve block, just like getting a dental shot before a procedure. If it at the right nerve site it will remove any discomfort almost immediately.

While I am not an MD, your pain meds shouldn't make any difference, unless they stop you feeling *any* pain. You will know if it works.

MickM
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RFA after spinal cord stimulator ?

I'm scheduled for nerve burn 2/8/2011. I already have 3 fusions and a spinal cord stimulator which does help but still have pain and don't want to keep doing all the pain meds. What are the downsides of this procedure? I really need some advice, Thanks Mick

SteveC
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Hi Mick, I would say there

Hi Mick,

I would say there are no drawbacks to it, apart from having no leg control until the local anaesthetic wears off, and the injection site being tender for 1-2 weeks. You don't end up with a numb leg or even a numb patch of skin and it is not permanent deactivation/destruction of the nerve. IMO I would say it is worth a shot. I believe the worst that can happen is it not working so well. I think it would also be worth looking at a possible ortho referral and ask them if there is something else causing the problem, which can be more easily addressed e.g. muscle tightness is due to protecting vulnerable areas, why not try and find why the muscles are tight rather than just taking steroids.

I actually just saw my doc as the relief was not as long lasting as it should have been (possibly the removal of 1 pain source led to another one becoming aparent). So I went to see a physiatrist who specialises in backs and she said she believes my problem is not 100% SI, maybe 20% with the rest from my disc bulge. She also noted that my back muscles are tight and the general area of my discomfort is more tender and thinks there is a lot of compensating going on. So she referred me to a colleague/PT who specialises in back rehab...have to see how that goes.

Good luck!

SteveC
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Hi Mick, I would say there

Hi Mick,

I would say there are no drawbacks to it, apart from having no leg control until the local anaesthetic wears off, and the injection site being tender for 1-2 weeks. You don't end up with a numb leg or even a numb patch of skin and it is not permanent deactivation/destruction of the nerve. IMO I would say it is worth a shot. I believe the worst that can happen is it not working so well. I think it would also be worth looking at a possible ortho referral and ask them if there is something else causing the problem, which can be more easily addressed e.g. muscle tightness is due to protecting vulnerable areas, why not try and find why the muscles are tight rather than just taking steroids.

I actually just saw my doc as the relief was not as long lasting as it should have been (possibly the removal of 1 pain source led to another one becoming aparent). So I went to see a physiatrist who specialises in backs and she said she believes my problem is not 100% SI, maybe 20% with the rest from my disc bulge. She also noted that my back muscles are tight and the general area of my discomfort is more tender and thinks there is a lot of compensating going on. So she referred me to a colleague/PT who specialises in back rehab...have to see how that goes.

Good luck!