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Radiofrequency Ablation
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jujulang posted:
I had the RFA on my right side last Wednesday at L1,L2,L3,L4 and L5. I am still pretty sore and my lower back is still pretty painful. Most of my pain has been in my legs but I've heard from several people that this procedure doesn't help with leg pain. My Dr's are pretty confident it will work as the nerve blocks were great success.
I have to go have the left side done on the 26th.
He also put a little steroid in L5.
Has anyone had leg pain that this procedure has helped?
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davedsel2 responded:
Hello.

My wonderful wife had the same procedure (without steroid, though) on Friday 2/21/14 and Friday 3/7/14. She is experiencing some relief from her original back pain at L4/L5 that was caused by a work accident in 3/11, but she is having more pain down her legs. From what we understand this is fairly common and should diminish over time.

The RFA should help the leg pain more eventually since it is probably being caused by the spinal issues.

Definitely mention this to your doctor if it is still there before your left side is done, and at your follow-up appointment.

Please keep us updated. I will continue to pray that this does give you pain relief.
Please click on my username or avatar picture to read my story.

Blessings,

-Dave
 
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jujulang replied to davedsel2's response:
Thank you Dave. I'm thinking positively! Hoping your wife is doing well also.
 
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davedsel2 replied to jujulang's response:
I had an appointment with the physiatrist today and my wife came with me. He asked how she was doing and she told him about the pain in her legs. The doctor said that an epidural will help with that, and when she sees him for her follow-up on April 9 they will schedule that procedure. Yes, we see the same physiatrist now.

So, you may need both the RFA and the epidural for complete relief.

Thanks for you positive thoughts and kind words.
Please click on my username or avatar picture to read my story.

Blessings,

-Dave
 
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jujulang replied to davedsel2's response:
I had the epidural already with no relief at all. I had bilateral done 3 times last summer. I'm really hoping for this to work.....
 
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beauxla responded:
Jujulang, Radio Frequency Ablation (RFA or Rhizotomy) are performed for chronic axial back pain due to facet related pain or chronic spasm. The facets are usually the problem when you lean forward and feel better but is you lean back you get pain in the back or spasm not legs normally. Traditionally a pain management doctors will do a facet or medial branch block under X-ray. If this takes away 80% or more of your pain patients usually get results from a RFA. However, clinically the published results are typically 60-70% of patients get pain relief for 3-6 months. If your pain is in your legs past your knees this usually indicate something pinching your exiting nerves (sciatica)

If you didn't get any pain relief from the previous RFA I wouldn't go ahead with the other. Pain management drs sometimes stagger the procedures from one side to the next over a few weeks to get paid more. What type of nerve block did you have? If they were as a explained above medial branch blocks and you did well from them but not relief from the RFA Its not adding up to me.
 
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jujulang replied to beauxla's response:
Well, the nerve blocks worked amazingly and I had both sides done with RFA. It's been a month for one side and 3 weeks for the other and I must say not much improvement. In fact, I am now getting leg and foot cramps nightly. I am so discouraged and so sick of procedures that I don't even know what to ask for at this point.
 
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bj1208 replied to jujulang's response:
Hi jujulang

Can u describe more in detail what type of leg and foot cramps u are having?

I'm wondering if the problem is more of and underlying problem meaning u have something more going on with ur spine whereas a bulging disc could be pressing on the nerve root causing the pains.

I had problems of going from one pain clinic to another starting over with procedures . Pain clinic docs saw $$ and I didn't know any better not knowing what was going on with my spine.

I truly believe u need to get a second opinion from a spine specialist either Orthopedic or Neurosurgeon Spine Specialist and having a MRI or CT Scan done possibly with and without dye injection as this will show more if what's going on.

Seeing a good pain specialist too would be beneficial
A PHYSIATRIST Pain Specialist would be my preference as they go deeper into pain management by treating the underlying problems of pains and if previous treatments didn't work they won't try to repeat treatments unless they were not done properly or in the right area.

I hope this helps please keep us posted~~
~~ Click on my name or picture and read my story ~~
~~ Joy ~~
 
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jujulang replied to bj1208's response:
Sometimes it's general pain (achiness), sometimes it's pain that is radiating from my lower back down my hips , around the sides of my thighs, down to my knees around the sides of my calves and into my ankles. I have had the true sciatica pain lately, in the back, down the butt and the back of the thighs.
The foot cramps are happening mainly when I lie down and they are in the arch of the foot up into my leg above my ankle.
The pain in my leg will get better if I stop walking and then I am left with tons of muscle twitching until things calm down.
I know that I have bulging discs, some degeneration and some mild stenosis. I've had 6 steroid shots, 2 nerve blocks and now 2 RFA on L2,3,4, and 5.
 
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bj1208 replied to jujulang's response:
Hi again -

I'm in agreement with Beauxla's response - this doesn't add up and now that you have given the DX of your spine I can see why.

I really think you should get another opinion from either Orthopedic or Neurosurgeon Spine Specialist and have a CT Scan done with and without dye. I really think your problems are being caused from your spine issues as these will pinch on a nerve root and cause lots of pains.

I don't believe the RFA's and nerve blocks are going to do any good unless you get down to the bottom of the problem - the bulging discs, stenosis and the degenerative disc disease.

When you sleep at nite it would be best to use extra pillows - under you knees if sleeping on your back and between your knees when sleeping on your sides - make sure you have your foot on the pillow and its not hanging off (I use 2 pillows side by side so my foot rests on a pillow).

Seeing a good PHYSIATRIST Pain Doc would benefit you too as they go deeper into pain management. They may request an EMG and Nerve Conduction Test - this will show if there is any nerve damage and will also be able to tell which disc(s) are causing the problems.

I have this done each year to check the damage in my legs. and with my pains being on the outside and inside of the legs they know which discs are the problem makers.

Please do get another opinion and see if there are any PHYSIATRIST Pain docs in your area. There is a search engine at the top of this page labeled "DOCTORS". you can put in the info and it will give you the ones in your area.

Please keep us posted~~
~~ Click on my name or picture and read my story ~~
~~ Joy ~~
 
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jujulang replied to bj1208's response:
I have a call in to a neurosurgeon for an appointment. I am not one to take pain meds or any pills for that matter I don't know that I would be any better at the thought of surgery either.
I have had the EMG done and no nerve damage was found.
CT scan is much quicker than an MRI isn't it? Unfortunately very claustrophobic.
 
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bj1208 replied to jujulang's response:
Yea CT Scan us a lot faster. I am claustrophobic too and my docs always prescribe Valium to take before so that helps.

Keep us posted.
~~ Click on my name or picture and read my story ~~
~~ Joy ~~
 
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jujulang replied to bj1208's response:
I went for my follow up on the RFA yesterday and was scheduled to see the PA instead of the Dr and she advised me there was nothing more they could do for me. I told her the Dr told me in the procedure room that if this didn't work he would order more imaging. She told me that she couldn't believe he would say that as I already had an MRI and x-rays. She asked me if I was sure I didn't want the neurotransmitter implant and I said yeah, I'm sure. She said well ,then there's nothing more we can do. I was soooo mad I told her there was one more thing they could do for me and that was to send my notes over to the local Neurosurgeons office . She actually told me there was nothing that could be done for me surgically either.
Sorry for the rant but I can't believe she said this. I'm going to wait a few days to see if the Neuro office calls me with an appointment. I swear he hit some of my motor nerves because my legs have been feeling a little weaker too. I really hate this stuff..............
 
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bj1208 replied to jujulang's response:
Hey there I'm really sorry this is happening. That's a chicken way to handle patients.

I had a pain clinic doc that during a disco gram when he couldn't find where my pains were coming from that he said he gives up. I'm laying on my stomach.and I could see his shadow on wall and he threw his arms up making that statement. I didn't know til a month later when I trued to get refill on my pain med and it was denied that he had released me as a patient. That's when I started going to a PHYSIATRIST Pain Specialist.

I.think that's the direction you need to go. They have a set of spine specialist they work with and can make sure you get the proper treatments. They listen to you and will only do treatments if you agree. They don't push anything on you. They can order tests (CT Scan with and without dye) .
Please keep us posted
~~ Click on my name or picture and read my story ~~
~~ Joy ~~
 
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jujulang replied to bj1208's response:
I went to see a highly recommended neurosurgeon last week and the gist of the visit was that my leg pain is from "anxiety". He looked at my MRI and xrays and told me that I have a remarkable looking spine for a 56 yr old woman and that I should never have had RFA done for leg pain, it was a waste of time and my insurance company's money.
According to the Interventional Spine Doc, I have 3 bulging discs, some degeneration, mild curvature, mild spinal stenosis. Looking at the MRI written results, it indicated some bulging and the stenosis and was " unremarkable".
On the questionnaire that I had to fill out for the Neurosurgeon it asked if I was being treated for any mental illness/anxiety and I answered yes, I take alprazolam for sleep and I've been dealing with anxiety issues for 30 years. I feel he took that and ran with it and now I feel like it's all in my head and I know darn well that it isn't. I just don't know what to do from here. I have signed up for some PT and will see if that will help although I have gone that route before and it didn't. I hate to think that I have to suck it up and live with it.


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