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Radiofrequency Rhizotomy/ Ablation

AnonymousUserAAnonymousUser Posts: 49,293
edited 06/11/2012 - 8:22 AM in Lower Back Pain
I am thinking about having radiofrequency rhizotomy in my lumbar facets. (for sure L4-5 and L5-S1). I had this in my neck at C5-C7 and then ended up having a fusion later. It helped a little, (the RF)but I also had severe disk disease and this rhizotomy stuff is for arthritis. My lumbar pain is mostly from arthritis. There is some stenosis, but not enough for surgery. I have a limp and it really is limiting my life now with standing and walking. I HAVE to get back to work as an elem. substitute SOON. The spinal guy recommends PT (forget it...been there..done that from April till July. Unfortunately she focused more on the SI Joint than the facet joints. I never did much core strengenthing because of the pain. I am kind of in a time crunch because A) I have to get back to work and B) my insurance will pay 100% of ANY procedure until Jan. 1 because I met my OUT OF POCKET MAXIMUM for this yr. My PT was for the SI Joint and not my lumbar facets. (OY). Now I feel like I wasted 3 months because the whole time I was in too much pain to do the exercises. But I also dont have the luxury of wasting my time with PT right now. I have to get better sooner rather than later.You know how it goes.....Aug. goes into Sept. Sept. goes in Oct..... Plus I need time to recuperate from a rhizotomy. I dont see my physiatrist till next Friday and I know him. He will agree with the spinal guy and set me up for that diagnostic nerve block first I laready had facet injections that only worked for 5 days AND epidurals) and then I guess the rhizotomy. For those of you that had a RF RHIZOTOMY OR ABLATION did it help you stand and walk better????????????? God, I would be so happy if I got improvement. Celebrex helps, somewhat...but not enough. I end up having to take Vicodin by the end of the day because its such a killer.


  • I also answered your other post. The rhizotomy is the thing that helps my pain the most! definitely try it. I have this done about 1 x a year as it takes about 1 year for the nerves to regenerate. It helps and pretty much eliminates the pain going down the leg. My doc says that it is very important for patient to be awake during procedure to communicate when the pain that you experience is recreated so that they know for sure they have the correct nerve. Go for it without a doubt. Good luck and let us know how you make out.
    PS this works better and longer than the steroid injections.
  • Thanks for replying. I am definitely going to go for it.
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  • Hello,
    As you know I went last week for the ablation on L3,L4, and L5 both side 6 nerves done. Dr. felt if the injections were working and not holding he had no problem with a Dr. putting me to sleep for this. I am a big chicken too tho. Have the sleep Dr. always their even for the injections that only take 10 min. I can tell you people are shocked that I have no pain after 6 nerves done and went right back to work Mon. and have a very demanding job for bending lots and lifting. I am now after a week a little sore but, ice works. Not the pain I had before the ablation. I know everbody is differnt and do have pain after. I was a lucky on for once. I wish you so much luck with this. Again for me this worked so far. I have red marks all over my arms and hands from too many steriods I think. Good luck and Blessing to you.
  • Please keep us posted.
  • Hi SKZ. I have a bulging disc L4/5 and osteoarthritis, and now spinal stenosis. This is the second time I have had RF. They did L4,5 and S1. I am having less pain everyday now and kind of sit on pins and needles because the first time I had RF, (about a year ago, I got so very little relief because I don't think they could get to the nerve that was so surrounded by the arthritis and bulging disc. I'm not sure that this makes any sense but after I got no relief my pain management DR said I should have surgery so I went and got another MRI and I'm too chicken too have it done. I think I researched it to death and am so tired of having been in pain and taking meds for so long that I don't want to go through the recovery time. A couple of months ago, I stopped taking Celebrex because it made my heart race and I was fine w/that but continued to take Vicodin. Now I have been able to go back to one 50 m ultram a day and a naproxen once in a while and some days a hot/cold patch. I think this RF was successful and due to someone in chat here, know from last RF that I need to use this time to strengthen my back as much as possible. This is just my experience and I don't know that it will help but I know that whatever we can do to be more mobile and in less pain has to be done not only for our backs but for our sanity.
    Best Wishes to you SKZ as I know long ago you were one to reply to one of my posts because our pain locals are similar.
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  • Hi, I had RF done on Friday and I must say I have noticed the difference already. I can bend where I couldn't before. Unfortunately i have hip busitis which is killing me so it kind of overshadows the back, but I think it has definitely stopped the pain.

    My doc said definitely not to be awake as no-one could cope with the pain of a nerve burn. They do get you to stay awake while they do a test nerve block, but not the actual burn (at least here in Australia).

    I would give it a go, i dont think you have anything to lose. I seemed to have tried everything else, so hoping this lasts long enough to get some core strength.
    All the best.
  • About 3 months ago I started having severe pain in my lower back and down my right leg. I had an MRI done and it came back with some arthritis and a bulging disk. I am 28 years old, and have had injections done in my middle back, which worked great, and 2 weeks ago had some done in my lower back which worked for about a week. My doctor suggested that I have a rhizotomy done in my L4-5 and S1. She wants to do both sides of my back at the same time due to insurance issues. How much pain can I expect to be in afterwards? I do not take narcotic pain killers, so I'll be taking regular tylenol. She told me that it helps most people that injections do not help for. I have done some research on the internet and some places say its a 50/50 shot, while others say higher. What have been your experiences and has it lasted a long time? Also, she wants me to do physical therapy afterwards. Did this work for any of you? Is anyone worse off after having it done than before? Thanks so much for your help!!
  • I'm waiting for Comp to approve this. I have 2 herniations, L4-5 and L5-S1 due to a lifting injury 4 1/2 years ago. I live on Norco and Ibuprofen and still work full time. After 10 LESI's and a Transforaminal, the doc's finally tried Facet blocks, which gave me some relief. I'm excited about doing this! I hope I can cut down on the Narcotics. I'm not hooked on them, but it sucks when I can't take them. I won't drive with them in my system, so the weekends are out. Everything I have read about the procedure has been positive. I just wish Comp didn't take so long to approve everything!
  • I am also hoping this works....As I just had my first facet injection today, due to insurance issues they say I have to do one more next week...then go ahead with the RF. So far tonight, my left side they did the injection on, is feeling MUCH better.

    I like you am on the Norco 10mg, however I have to take about 3 a day..with my flexeril. however still can't find a good extended release pain killer I like...I have tried kadain ER, ultram er, ryzolt er, and now opana er. the Opana and kadain give me way to many sides to be functional...and the ryzolt and ultram was like taking a asprin for a bullet in the head.

    so lets hope this RF works, and I will keep you all updated. They have to do my L5/S1...L4/L5..and L3..UGHH.

    However I do now feel I am hooked to the vicodin, because if I dont take it, I get very stiff and sore muscles and joints...the sooner I can get off this crap the better, I hate the feeling of drugs controlling my life.
  • The injections are to determine if the Rhizotomy will even be effective. Basically they flood the nerve with pain killers (same nerve they burn in the RF procedure). For me there were two injections, one with a short acting pain med (xylocaine) and the second with a longer acting pain med (marcaine). The doctor didn't tell me what order I had them in, I had to tell the doctor if the injections worked and for how long. They call these injections a trial, and they are required before the RF procedure is done.

    For me, one injection actually worked, for like 3 days. I was in heaven for 3 days!! The other had no effect. I then had the Rhizotomy and it ended up not working for me.

    One of the known common side effects is muscle spasms, which they'll give you a muscle relaxer for and your pain will most likely feel worse for a while because of the spasms. It could also take up to 8 weeks for the procedure to have an effect. My pain level went up a bit but I didn't really have any spasms, at least not more than before. Even though they didn't help me, looking back I still think it was worth the attempt. It really was as easy as having an injection, 3 levels took about 30 minutes.

    I hope they work well for you and give you some relief!
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