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Just had Facet Joint Radio Frequency Ablation - not too bad!

Another term for the procedure I've just had this morning is facet rhizotomy. Many have posted about this, but I thought I'd share my experience as I go. I was a good candidate for this following two spinal injections this Feb and March that gave me virtually 100% relief, but only for 14 and 9 days. My pain is at L4-L5-S1, and it grew over the past year so that I felt truly disabled. I have a wonderful PT, but I can do only a limited set of exercises, and I've found it frustratingly easy to over do. I love to travel, but sitting long is painful. I love my active grand kids, but I couldn't come close to playing with them. I'm 59, and while I've seen a rheumatologist for years, this lower back pain has escalated markedly just this past year. I'd go home from work and spend most workday evenings in bed.

My reasons for trying this RF is to hopefully have near full relief of pain for - what - 9, 12 months? I plan to do exercises given by my PT, really work on the weight (9 lbs gone, 30 more to go), and continue water aerobics this summer (I'm a teacher).

BUT - main reason for posting! ------->
We all know everybody reacts differently to pain. I'd read so many horror stories about this procedure that I really had to set myself up to do it. It just wasn't that bad! It was a tiny notch up from the injections I had earlier, but that's all. I did not have IV pain meds, I had only 1mg of Lorazepam the morning of the procedure for anxiety. The whole process took about 1 hr 15 mins before I was waiting in recovery. I'm told these first days won't be fun, but I'll post here. Again, pain's unique to each of us, but the pain of this procedure, for me, was not significant, little beyond the injections, and well worth the hope I have of pain relief for months to come.
L4L5 facet joint pain, rhizotomy


  • Without taking time to Google this procedure, can you tell me something about it? I'm doing everything possible to keep from having major surgery.
  • Roxanne,

    I, too, am trying to steer clear from surgery of any kind as long as possible.

    Briefly, this is usually done by a pain specialist, often an MD who is an anesthesiologist. Two successful steroid injections are required to be a good candidate. My understanding is that most insurance won't cover it without those.

    If they help, even for days, it's an indication that this will benefit you. But, like anything medical, I do suggest you research it and/or find a good pain specialist.

    The long-acting numbing agent he put in before burning the nerves is just now wearing off, 12 hours later. I'm glad I was warned not to get too excited after this or the injections. This temporary numbing thing makes you forget you have any back pain at all! They're waking up, and I'm thinking it may be a little bit of a rough night, but so far - not more than a bad, I've overdone it, kind of a day.
    L4L5 facet joint pain, rhizotomy
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  • You can find great info, Roxanne, right here on this site:

    Not sleeping Night #1, but not in much pain either . . . .?
    L4L5 facet joint pain, rhizotomy
  • Thanks for the information. I've only been to one pain doctor, after seeing three neurosurgeons. I've had five steroid injections, and now Blue Cross sends me a message stating that they can cause spine fractures in women with low T-scores. Mine's a -2.1 now.
    Anyway, back to the pain surgeon. He told me he couldn't help me any longer after looking at the last MRI report. Plus, he cancelled the surgery for my synovial cyst.
    Tomorrow is my appointment with yet another neurosurgeon who removed thissame kind of cyst without fusion.
    I'm 69 years old but don't feel it. However, I'm payfor for all of the heavy lifting that I've done in my life-on the job and in the gym.
    I do hope that both of us can keep from having any kind of major surgery. Hang in there and keep me posted. I'll let you know what this doctor has to say tomorrow.
  • The neurosurgeon that I saw this morning said he could take the cyst out without fusion, but he wanted to do lumbar decompression to take care of the pinched nerve. He said this would probably take away most of my hip/leg pain, but I would probably have future complications from a disc that's "moving".
    Lumbar decompression scares the heck out of me, after hearing stories from some people. Also, I would be off work a month, and I would like to be back in two weeks, due to the fact that my work is cyclic.
    Right now, I am very undecided.
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  • I don't know what that is, but I'm for going slowly. We joined this board about the same time, or I got active about the time you joined. So I don't know as much as others here might . . . but that never stopped me from "talking"! I can only imagine that relief from a pinched nerve would be heavenly, but what's this about future complications? I think it's good that he's being open w you about possible concerns - some might not be. Can you afford a second opinion? Is going back to work in pain a key issue? I hope it's OK for me to say I wish you didn't have to work, even at a young 69.
    I'm in the weird position of beginning to experience some pain relief from the ablation while also hearing my spine "clunk" now that I'm getting more active again. I don't think it should be doing that - I'll be getting back to PT to see what I can do to build my core. Best to you as you wrestle w this decision.
    L4L5 facet joint pain, rhizotomy
  • Thanks for the input! This is the fourth neurosurgeon that I've seen. Each had a different story. I asked this one about the procedure that you had, and he claimed I needed the nerves going from my hip to my legs. The main reason I went to him is because he has performed synovial cyst surgeries with fusion. He "peels" them out, so to speak, and he's only had one come back without fusion. I can't have fusion if I wanted it, after telling him what my T-score was.
    In the meantime, I'm going to get back to weight lifting and core exercises, not to mention stretching exercises for the pinched nerve. And I'll just take a Tramadol before I run. Ha. I may be in pain, but I'm still going".
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