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Chronic sciatica after (!) pulsed Radiofrequency Ablation (PRFA)

freddy88ffreddy88 Posts: 4

Hi everybody,

I am a 27-year-old male from Switzerland and I’ve been suffering from chronic sciatica 24/7 for more than 1 year. This continuos pain is driving me crazy and the more time passes, the more I start to feel hopeless, impotent and depressed about it. Everyday activities like driving, having a romantic dinner, watching TV and even reading a book are getting difficult to enjoy because of the pain kicking and radiating in my leg. Moreover most of my friends and family do not seem to realize how bad I feel. I think they just don’t understand how debilitating and psychologically overwhelming chronic pain is. I honestly feel like sciatica is ruining my life and I have a hard time keeping a positive attitude toward my future.

Since no doctor has been able to give me a proper diagnosis so far, I would like to share my story with you as I really hope that by doing so, some of you who experienced a similar situation, may give me some useful advice. I am sorry about the length of my post, but I wanted to include as much information as possible, knowing that even a small detail can be useful to identify the source of the problem.

Everything started with a car accident I had back in 2010. I was hit by a car and I reported a small right pelvic fracture plus some intense back pain. The lumbar X-Rays showed a light spondylolisthesis of first grade at L5/S1 level, that never caused any pain until then (all doctors agreed that it was congenital).  Since this accident, I started having some light lower back pain but nothing too serious and I continued to go on with my life like I always did. 

Some years later, in July 2014, I was wakeboarding and after a jump I fell badly on the water and I hurt my back. It was quite painful and I thought that I may probably have had a herniated a disk. As a result, I did an MRI and a CAT that turned out completely normal.  The doctor advised to do some regular morning exercise and slowly the pain improved over the next 3-4 months. 

At the beginning of November 2014, while I still had some back pain from the fall, I met with a new Neurosurgeon. He told me that he might try an amazing procedure on me, the pulsed radiofrequency ablation (PRFA), which may eliminate my pain for up to one year. He said there were no relevant side effects and that there would be a 50-70% success rate. I was obviously very interested about it and I agreed to try this procedure! He first did some cortisone infiltrations on my L5/S1 facets to see if my back pain would improve. I didn’t notice a relevant improvement but I still felt like the PRFA may be worth a try, since the doctor said that the only side effect would be that it wouldn’t make any difference. I spoke about that with him (telling him also that I didn't notice any relevant improvements with the infiltration) and on November 22, 2014 I let him do the PRFA. Well, everyday since that day, I regret my decision to undergo the PRFA!  On the first 3 facets I just felt a normal pressure, while he was putting the electric current in the nail. But on the forth facet I felt a strong and intense pain radiating down the sciatic nerve of my left leg. I was screaming in pain, telling him that my leg was hurting a lot, and after few seconds he stopped the current.

He said that everything was perfectly fine and that it can happen that some pain in the legs is felt during the procedure. The back pain didn’t improve much, but few days after the PRFA I started, to notice some strange pain in my left leg. It slowly became more intense and since then it never went away! I never experienced sciatica before in my life but it soon became by worst nightmare. From the moment I wake up, until the moment I go to sleep, I can feel a continuous pain in my left leg (I would describe it as a strong compression/ pressure type of pain). From a scale of 1-10, the pain is a 3. Most of the time it is not an acute pain, but it is bad enough to interfere with the enjoyment of most everyday activities. The pain starts in the middle of my thigh and goes down until slightly below my knee. Most pain is focused between the knee and the middle of my thigh. Luckily I don’t feel any pain in my buttock, nor in my feet. I feel the most pain when seated and also when lying down. It becomes less noticeable when standing or walking, because the body movement seems to hide it. The pain is also alternating: some days it is stronger and some days it is less painful. It is less strong in the morning, after I wake up.

I tried many things including chiropractic, physiotherapy, acupuncture, 150 grams a day of Lyrica, but until now nothing has worked. I recently did another lumbar MRI, an EMG and even a sciatic nerve MRI and everything turned out normal (no herniated disk, etc.). It looks like everything in my body is perfectly fine, but the pain is always there.  I had talks with 2 different neurosurgeons and a neurologist and none of them managed to give me a diagnosis! They do agree that the PRFA is almost certainly the cause of my pain but they don’t understand how, since it is usually used to remove pain and not create it. A neurologist told me 8 months ago that the pain should slowly go away as the nerves (which may have been damaged during the PRFA) regenerate. Unfortunately I didn’t improve over time and I steel feel like in November 2014.

Two weeks ago my current neurosurgeon tried to make an infiltration of cortisone on the root of my L5/S1 level, but unfortunately I felt no reduction of the pain at all! It didn't have any effect. Honestly I don’t know what I should try next… I feel like I tried everything and the more time passes and the more I feel depressed by this continuous pain and I am giving up hope to get back my life!

Thank you in advance for reading my story. I really hope that you will be able to give me any piece of advice. It would be much appreciated! 


Federico

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1

Comments

  • SavageSavage United StatesPosts: 7,385
    Sue
    Honorary Spine-Health Moderator
    -------------------------------------------------------------------------------------------------------------------------
    Please read my medical history at: Medical History

  • SavageSavage United StatesPosts: 7,385
    Hello Frederico.......
    You mentioned that what some people would consider simple  activities cause you pain, ..ex..you mentioned going out to dinner.
    Curious if your pain increases with certain positions, like sitting?
    You may have mentioned it and I just missing it.

    My initial experience with sciatica was only having outer calf pain, left leg.
    It lasted quite a while, to where my primary doctor said she could not help me and she referred me to pain management doctor.
    There with PM variety of testing, I was able to become stable ...and out of the ER..as other spinal issues were discovered and became symptomatic, also.

    It can take quite a time, in my experience, for discovery of cause of issue and then the trial and try again of treatments and or medications to take the edge off of the pain.
    You mentioned your pain level at a three. Would you mind to say what pain level was prior to PRFA?

    You mentioned working with a neurosurgeon. That sounds like your in good hands.
    And then information from neurologist, seems like you are getting good care and good communication from doctor.
    Im assuming you are also good at communicating to doctor and that is so important.

    I went through my own experience of feeling depressed with the chronic pain lifestyle, and as something you mentioned....mine was complicated with my loved ones not understanding what I was going through.
    With time, I started to realize how difficult it must be on them, ....as  I didn't even know how cooperative  my body would on any given day...let alone minute or hour.
    I started thinking that if I wasn't living with this chronic pain, I'm not sure I'd believe it.

    It is also very difficult to watch a loved one suffering. They too can feel helpless as they want to help you.

    Please realize, there is always hope! The pain, the nerves, ..things take time to settle down.
    When you are used to being so active and are so young, I would think it easy to become restless.
    And it does take time!
    It's very good to comply with any limitations and or restrictions doctor has given you at this time.

    What I also found useful was a discussion on this site called, The Blend.
    Its not like a recipe, but more of a concept....for me with ideas I tweaked for my own personality to distract my pain...and ways to occupy myself with my limitations and still feel useful....and more....

    You can find it by using the search on this site, upper right on page.
    You may also want to use search for any of your concerns...from your sciatica to family issues...
    You may be led to current or past discussions. You may also be led to the medical side on this site, with articles and or videos. Very informative.

    Often time when I use the search, I find I have more questions..then I jot down to discuss with doctor.

    I will be very interested in your thread ..other members shared experiences, and how you are getting along!
    Imhope it helps, even in a small way, for you to know...you are not alone!







    Sue
    Honorary Spine-Health Moderator
    -------------------------------------------------------------------------------------------------------------------------
    Please read my medical history at: Medical History

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  • MarWinMarWin OhioPosts: 701
    It is my understanding that sciatica can be a result of a disc putting pressure on the nerve or possibly the piriformis muscle putting pressure on the nerve. In my case it was the disc, but I sure felt it in my butt via the piriformis. Ultimately I felt it down my leg and in my toes. Unlike many others, I never felt in my calf. I struggled for two years with sciatica. The only thing I've ever found that has worked for me is Postural Alignment Therapy via the Egoscue Method. To me, no other method makes more sense. I now work daily with my routines to keep my posture properly aligned. I've been fortunate never to have had back surgery, so I could never speak to the legitimacy of this therapy working for anyone who has. 
  • Dear Savage and MarWin, 

    thank you very much for your kind answer. 
    I appreciate your opinions a lot. 

    I just went to a new neurosurgeon and he also doesn't understand what I have. 
    I am so sad and hopeless because I really don't know what to do now. 
    Apparently my body looks just fine but my pain is always there... did the PRFA somehow damage my nerves? 

    I really don't know what to do... please help me! 

    Thank you :-) 

    Federico 
  • SavageSavage United StatesPosts: 7,385
    Hi freddy......
    Curious if you have had an EMG to maybe double check out which nerves are problematic?
    Sue
    Honorary Spine-Health Moderator
    -------------------------------------------------------------------------------------------------------------------------
    Please read my medical history at: Medical History

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  • Hi Savage! Thank you for your answer! 
    Yes, I did an EMG that turned out completely normal. 
    The source of my pain is still a mystery. 

    I just had an appointment with a new physiotherapist who suggest for the first time, that my pain may be the result of a "secondary hyperalgesia" as a result of a wrong Radiofrequency, but he couldn't offer any advice for a therapy. 
    The mystery is still there.

    I really don't know what to do anymore... 

    Thank you for your help! :-) It is much appreciated! 

    Federico 
  • gmjonesggmjones Merthyr tydfilPosts: 7
    I suffered sciatica for almost 2 years, the severe cramping ion my calf when I walked, or stood was unbearable and nothing would stop it. I had a herniated disc, stenosis and osteoarthritis,min then had epidural injections which didn't work. Although it was very painful I tried to keep fit by doing Pilates. One month ago I had surgery, I was terrified as my doctor was dead against it but the surgeon said I had 85% chance of it working. The day afte my operation I stood up and walked and for the first time in almost 2 years I was pain free, I thought it was a miracle. I only have some discomfort where I had surgery and I am getting stronger every day. I can't walk for long periods yet and it will take 3 months for the screw and rods to fuse, but I feel like a different person, but I think you have to be guided by your surgeon.
  • SavageSavage United StatesPosts: 7,385
    Hello gmjones.....
    It is very good to hear you are doing so well!
    I wish you the very best with your continued recovery!
    Sue
    Honorary Spine-Health Moderator
    -------------------------------------------------------------------------------------------------------------------------
    Please read my medical history at: Medical History

  • Just a short update: I've noticed that the pain is less strong during the summer, when it is hot, and it starts getting strong again in winter. As for a diagnosis, it is still a mystery. Anyone has any more suggestions? Thank you!
  • HI Freddy 

    I realize that it has been awhile since your troubles. I am having problems very similar to yours following a radio frequency ablation surgery to my lumbar. Our symptoms are very similar. The pain ranges in intensity from 3-4 to 10. I received a nerve block but have not yet gotten any relief. I was wondering how long your pain lasted? 



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