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RFA
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David Maine, MD posted:
I have seen a fair bit of discussion about RFA lesioning on the Exchange. Here is a bit of an overview for those interested in learning more about this topic. Happy 4th to all!

What is Radiofrequency lesioning (for pain management)?
Radiofrequency lesioning uses the heat produced from radiofrequency energy to disrupt nerve function. The procedure temporarily blocks transmission of pain signals. Radio frequency lesioning results are not permanent. The nerves will grow back, and pain may return in six months or longer.
What is the medicine used in the procedure? Are there any side effects?
A numbing medicine and often steroid is placed around the nerve to decrease pain during the actual lesioning process. This is a medicine that can help reduce inflammation and pain. Like most medications, it can have some side effects. For instance, it can cause fluid retention and raise blood sugar levels in people with diabetes. If you are on a fluid restriction diet or if you have diabetes, talk with your physician about managing these side effects.
Will the Radio Frequency Lesioning help my pain?
It is impossible to say for sure if the procedure will help you. In general, people who have positive results after a Medial Branch Block (for back pain) can benefit from Radio Frequency Lesioning.
Will the Radio Frequency Lesioning cure my pain problem?
The Radio Frequency Lesioning is designed to relieve pain for a very specific pain generator (not for the whole body). It is not cure for the source of your pain just a treatment modality. One major advantage of the procedure is that it might make it easier for you to exercise and to participate in physical therapy sessions. These and other forms of pain management may be part of your doctor's overall treatment plan.
How long will the pain relief last?
Generally 6-12 months if successful


How is the procedure done? Will it hurt?
Generally, the procedure is done with the patient lying on their abdomen. The physician will first numb the skin with a local anesthetic. You may feel a stinging and burning sensation with this injection. After the skin is numb, the physician will place the Radio Frequency needles using X-ray guidance (fluoro). Proper needle placement is confirmed with a series of tests requiring your participation. After proper placement of the Radio Frequency needles are confirmed, the physician will numb the area around the nerve to be treated.
Is Radio Frequency Lesioning safe?
Yes, this procedure is safe. However, there are risks, side effects, and possible complications (as there are with any procedure). You should discuss these with your doctor.
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Caprice_WebMD_Staff responded:
Thanks for providing all this great information, Dr. Maine!
Treat people as if they were what they ought to be, and you'll help them to become what they are capable of becoming. ~Goethe
 
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lorieeg responded:
I HAVE USED THIS TREATMENT FOR OVER 5 YEARS. THE FIRST PROCEDURE LEFT ME PAIN FREE ON THE LEFT SIDE OF MY BACK FOR 2 YEARS. SUBSEQUENT TREATMENTS WERE NOT HELPFUL OR ONLY MODERATELY SO. I THINK THIS HAS SOMETHING TO DO WITH THE SKILL OF THE DOCTOR, AS I AM NOW WITH A PAIN MANAGE DOCTOR WHO IS 3 FOR 3 IN PROVIDING RELIEF.LONG-TERM.

FOR PEOPLE WHO WANT TO TRY THIS (WHICH I RECOMMEND), DON'T GIVE UP IF THE FIRST ONE DOESN'T WORK FOR YOU. I AM ALSO ON PAIN MEDS AND PATCH, SO A COMBINATION OF TREATMENTS MAY BE THE ANSWER.

MOST OF THE DOCTORS IN MY AREA USE ANESTHESIA FOR RFL, BUT IT IS ONLY MILD DISCOMFORT WITHOUT IT.
 
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redcrosswcc responded:
I have had this procedure 2 times in just over 2 years and it worked very well. My rhizolysis was done on my 3,4 and 5 lumbar joints and lasted for about 14 months. It saved my ability to walk, sleep and stand for extended periods.
 
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mae527 responded:
I've had RFA done on C-3 and -4 twice in the past 2.5 years to treat neck pain related to a whiplash/impact injury and spinal instability due to Ehlers-Danlos Syndrome, Type III. The first procedure lasted about 10 months with a lot of relief and the second has lasted 6 or so with mild relief. Despite the painful aspect of this procedure, I highly recommend it! The pain relief helped me get way ahead in PT and perform better in college. I will probably continue to do it as long as it provides some relief.
 
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An_223278 responded:
I have had 3 or 4 RFL treatments, with mixed results. The first 2 lasted about 5 months. The last one helped for a week and only on one side. I am again in constant pain. It makes it really hard to sit for any period of time. I am also exercising regularly. I am sure that helps, even though I don't see any improvement.
 
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tycobb48 responded:
I had this procedure done three time. For me the best results were from the local. Recovery time was very quick, no lasting side effects, although I did have a numb spot on my neck for a few months.
To me the concept seems solid, just didn't work for me - turns out my condition(s) were worse than originally diagnosed.
I just wanted to say that if offered, give it a try. My experience with it was not bad - just not the results I hoped for.
 
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mybirds7 responded:
I have had L3 thru L5 on my right side and am now totally pain free for nearly 3 weeks. I have had 3 back surgeries for ruptured discs and nerve blocks several times. So far this has been my best pain relief and my family doctor specializes in pain management!!!
 
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An_223279 replied to mybirds7's response:
Would highly recommend RFA to everyone! In my case, I've had repeated occipital RFA's all successful (1st lasted 6 months, but now last 12 months). Only side effect problem I've had was left side of head, including jaw, ear, temple, was numb for well over 6 months; but has since resolved. No one has mentioned the thoracic area for an RFA?
 
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Corbeau responded:
would this procedure work for a dmaged sicatic nerve that leaves me in Chronic pain? i am disabled from failed back surgery.
 
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symedzeb replied to mae527's response:
I also have Ehlers-Danlos Syndrome, Type III and have a lot of cervical spine instability and basically have no relief from neck pain. I am very excited to speak with my doctor about the possibility of this procedure! My EDS has advanced to the point I have had to file disability in the last year, and because of other issues many of the meds that are used to try to control our pain are not a possibility for me, so this is a really exciting possiblity.
 
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annette030 replied to Corbeau's response:
I think the Doctor answered this question when he said no one knows which patients it will help and which it won't and how best to decide.

Take care, Annette
 
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cweinbl responded:
The success rate for radio-frequency ablation is 40-50% (http://www.painphysicianjournal.com/2009/july/2009;12;699-802.pdf ).
 
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ctbeth replied to annette030's response:
I had RFA twice and it was not helpful for me. My MD was honest with me about the percentage of successful pain management, the discomfort of the procedure, et al.

While it didn't work for me, I'm not sorry that I tried.

I've pretty much told my docs that I'd try anything for any potential improvement.

I didn't find the procedure too uncomfortable.
~ one day at a time ~
 
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twistermomma responded:
I have had this procedure done on my neck and low back. With this procedure I have been able to get off of the narcotic pain medications...don't get me wrong I still take medication but at least it isn't narcotic based.

I recommend this procedure...it really does help!


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