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Medial Branch Nerve Block and RFA - your experiences please?

Cath111CCath111 Posts: 3,553
edited 06/11/2012 - 8:37 AM in Spinal Injections
Hi there. Instead of putting this in my previous "Next step..." post, I decided to start a new one. Why did I just tell you that? I dunno.

Anyway, I'm scheduled for my first diagnostic medial branch nerve block on October 14 and if that works, I'll be scheduling a radiofrequency ablation.

Can you please tell me your experiences with each of these? I'm wondering what to expect with regards to pain during and after each procedure, or any other sensations that you experienced. Also, how did they work for you and how long?

I know everyone is different, but like everybody else, I'm hoping to get some advance ideas of what I might expect.

Thanks for sharing.


  • The medial branch block was great, for about 2 days. The RFA helps me alot and usually lasts 9 months to a year for me. It is not a pleasant procedure and you will not see results right away (takes about 4-6 weeks) but has always been worth having it done. Good luck.
  • My doc swears by the fact that it is imperative to be awake during a rhizotomy. You must be able to tell him when they hit the spot that recreates your pain. He said that if the patient is asleep it is like working blind and taking a guess at which nerves to burn. It seems to be true because the folks that I have seen that were heavily sedated or asleep did not have good results.
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  • I'm in the same boat you are in. I've had branch block injections (6 to 8 pokes per visit) in my cervical spine every 2 months since Feb 2009. It provides relief to my neck and shoulders for the day, but does not touch the constant headache in the back of my head. My pain mgmt doc is pressuring me to have the RF procedure. That is when I started searching for info on spine-health.com and from what I've read it seems like it will help about 50% of the time. 5% of the time the pain will actually get worse, especially when performed further up the spine (as in my case). There are a couple of articles on this site about RF you may want to reference for some facts. There is one message on this site from 4/2/09 titled "Burning pain after Radio Frequency Ablation to Neck (RFA)". I don't believe any response had positive feedback about the procedure. It has made me apprehensive to say the least. I'm just trying to figure out what to do myself. If you form any opinion or receive additional info, could you please pass it along as I am also in limbo with the Radiofrequency!
  • Hi Cath,
    I just had my RFA procedure today. I have to say that it went really well. The procedure was easier than my second diagnostic shot which was more painful than the first one. I was awake throughout the entire procedure. They did give me a valium to relax me. My pain dr also injected a shot of some pain medication to the area to help with later pain.
    As of now I am experiencing soreness and a little burning. THe nurse said I would have burning for a few days and then it will settle down.
    Hope this helps and your injections go well.
  • Donna, thank you for sharing your experience. I talked with my doc on Monday and because I didn't have clear positive results from the nerve block, they're trying to decide if it's wise to go ahead with the RFA.

    I had significant relief from my LBP, but the pain down the back of my legs, in my hips and tailbone were much worse after the shots. If we decide to do the RFA anyway, we're hoping that at least the hip pain will go away with the LBP, that it was just a fluke that the nerve block didn't help it.

    I didn't have any sedation for my nerve blocks, per my doc's PA's request, so I told the nurses at the clinic where I had it done that if I come back for the RFA, I'm going to insist on sedation because the blocks hurt so much. Two of them told me, "Oh, you'll have to be sedated, don't worry." Oh...okay...

    RBM, I've read the statistics on RFA and have seen many negative posts about it, but if my doc suggests I have it done, I'll have it done. I'm going to do everything I can to avoid surgery on my lower back. I've got significant issues at L4/5 causing all the pain and a diffuse disk bulge at that level causing the sciatica. I'm going to do whatever necessary to get the most relief without surgery and then I'll probably just live with pain for a while.

    Thanks again for the info, Donna. Please continue to update and let me know how you're doing.

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  • Thanks for your reply. Another one of my doc opinions informed me that most pain will return within months of having a surgery. So, I too will try just about anything to avoid a surgery. I seem to notice that the more doctors I go to to get additional opinions, the more varying opinions I get! Oh well, some people in life have heavier burdens to bear. I hope we all will find help, peace, and contentment. Good luck to you!
  • are not near as successful when the patient is sedated. My doc says that it is like working blind or taking a guess at which nerve should be burned if the patient is not alert enough to respond when the nerve that is causing the pain is stimulated. I tend to believe him because I have always been awake and always had good results. On the other hand I have seen folks here that have been sedated and the procedure was not successful for them.
  • I've had mixed results with RFA. I understand and agree with you that if the doc says "let's try this", then we're going to try it. Basically it's a vote of confidence between patient and physician at that point. I applaud you for having that type of relationship with your doc.

    The nerve that I didn't have any good results with (greater occipital), was later found to have some other pathology issues, so I can't even say that that is a fair judge of it not working. All it did was serve to irritate the nerve. However I have had RFA to the lesser occipital and some branches and it was quite successful.

    It is definitely in our own best interest to be alert for these procedures, that way we can make certain that the doc is targeting the right nerve at the right spot.

  • My understanding is that with the nerve block, it was not only to see if I got relief but so that if I did, the doc now knows exactly which nerves he numbed so I won't have to be alert to tell him. That's why I was not sedated for the nerve block.

    However, it could very well be that they mean they will sedate me afterwards to stop the screaming. LOL

    "C", I have 100% confidence in the team of doctors I have. I've been with this spine center for over a year and the only complaint I ever had was that one time I had to wait for over an hour before the doc saw me. I complained to the PA I saw and after that, at each appointment, if I was waiting even five minutes after my scheduled time, someone would come out and tell me how much longer it would be and apologize. I'm sure they put a "Waiting Complainer" sticker on my file. But, hey, the squeeky wheel...yada...yada...yada.

    Thanks everyone for your thoughts and experiences.

  • dilaurodilauro ConnecticutPosts: 13,434
    how did the nerve block go?
    Wasnt for the 19th, did it get rescheduled? I read too fast some times
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
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