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Nerve Ablation/Denervation

Hello all,
After a couple of years of debilitating low back pain with no success in treatments (including PT, meditation, prolotherapy, osteopathic manipulation, etc.) and after seeing nine specialist doctors, I'm starting to consider nerve ablation/denervation.
Does anyone have any experience with this? What were the results? What about side effects?
Any information would be very welcome. My main osteopath is on board with this plan since nothing else has worked.
Thanks in advance.

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1

Comments

  • memerainboltmemerainbolt IndianaPosts: 4,137

    While you are waiting for other members to reply, go to the search box at the top right of the page, key in "nerve ablation", scroll down past the ads. You will find a coupe of older conversations you can read but please do not reply as they are old.

    Sandra
    Veritas Health Forum Moderator

  • Thank you for the suggestion.

    After reading older posts on nerve ablation, my primary concern is that this model of pain management has varying results with most people reporting that it seems to help for several months... then the pain comes back.
    I was told that I may be able to do PT while the nerves are no longer active to rebuild my muscles, totally heal and regain my active lifestyle. I didn't read any reports from these forums that suggest that to be true.

    Has anyone been able to get back to having a normal life after nerve ablation? I'm 33 and have had no accidents or any real damage done to my back, but I've been in debilitating pain for 2 years...

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  • memerainboltmemerainbolt IndianaPosts: 4,137

    You can't go just by reports, as you well know. Everyone is different, every doctor does the procedure a little different. Besides, you hardly hear of the success stories. Very few members come back on to tell us the good, only the bad.

    I have also thought about having this done. I'm tired of the injections that only last a couple of months. Hopefully someone will reply.

  • Travis_Brown - I've had nerve ablations in both lumbar and cervical.  My lumbar ablations were done about 45 years ago.  I had injured my low back and the use of nerve ablations allowed me to avoid low back surgery.  I was able to rehab it and have not had issues with my low back since. 
     My cervical ablations were another story.  To be honest with you, the cervical ablations were primary a diagnostic tool.  I had multiple cervical ablations (over multiple years).  I also had three cervical ACDFs.  I will never forget the reply from the doctor that did my first cervical ablation when I ask him if the procedure was therapeutic or diagnostic and his reply was, "yes".  Translated, his reply was "it the ablation helps and allows you to rehab, great".  He went on to say that he had patients that would see him every 18 to 24 months for the same ablation, but they were able to delay or even avoid surgery.  For me, it was diagnostic.  My only options for some relief was surgery. 
     In summary, I think it is worth a try.  If you can get significant relief without surgery, great.  Just my experience.

  • Thank you both for your replies.

    Also, yes, having some perspective is helpful, and I appreciate that you pointed out that success stories are less often reported.

    If I get it done, I will try to remember to report my experience.

    Thanks again!

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  • Also, Sandra, I hope you find some relief.

  • Hi!

    Ive had multiple RFAs done, and have no trouble with my exercise of choice, which is swimming.  The ablations help for a couple months to 4-5 months.  Better than nothing.

    I just had a spinal cord stimulator implanted.  


  • My RFAs for my cervical issues were done around 2005 or so

    No issues other than the limitations caused by the nature of the damage to bone and muscles.

    My permanent headache was aleviated to a very manageable level.there was pain in doing it but it took away the debilitating neck pain,headache,nauseating levels 

    It was for me a painfull procedure..ad i metabolise anaesthesia like a person would not  believe.  It was a twilight and had to be awake for the doc to talk with me.

    The relief i got was worth it. Every "body" IS different and results will vary

    Pain tolerance, levels of suffering tolerance and your psychological makeup can affect your personal outlook on the success or failure of the procedure 

    For my case it made a world of difference

    Best of luck to you.

  • Thank you both.

    I go in to do a diagnostic nerve block soon. We'll see what happens.

    I'll report back!

  • William, did your pain come back after 12 months or so?

  • Hi Travis!  I'm actually having my second medial block done this week and will have the radio frequency injection (ablation) completed in early December depending on the results of the two blocks.  I'll try and report back and let you know how it goes.  This lower back pain and leg numbness has been going on for a year now. Like you, I've tried everything, hoping something will work.  I continue to do PT to strengthen my back muscles, but you'd think after six months I'd have found some relief.  

  • BitzicatBBitzicat PhoenixPosts: 68

    I had the nerve block diagnostic test yesterday.  I was supposed to get 80% relief immediately.  I did not.  They considered it failed but about 5 hours later, I felt better.  Not 80%, but better........ not sure how to proceed.  Anyone else have this result?

  • I had a cervical ablation done in 2016, it lasted me just over 2 years before the pain came back. I had another done at a practice I'm no longer with, that one had a marginal success. 2 practices down the road, I may consider another one.

  • L4_L5LL4_L5 Posts: 1,240
    edited 11/25/2019 - 4:08 PM

    @Bitzicat I told the doctor who did my injections “since you’re giving me fentanyl during the procedure what’s to say the pain relief for the first 4-5 hours isn’t really the injection working but rather the benefits from the fentanyl?” He said that was a good point. LOL. 

    Been nearly a week now since my injection. Unfortunately, it failed.

  • memerainboltmemerainbolt IndianaPosts: 4,137

    L4_L5 and Bitzicat

    I'm sorry the injection did not work. My PM doctor and I have discussed doing an ablation before but he is the one that said it would not help me At least he was honest. But if we were left up to me, I wouldn't do it anyway.

  • BitzicatBBitzicat PhoenixPosts: 68

    My point wasn’t that it didn’t work, it was I was expected to get 80% relief in 10 minutes.  Also, I could not take ANY medication for 12 hours prior to injection.  I was in a lot of pain from my fibromyalgia.  If I had taken those meds I would have possibly felt the difference.  I wanted to do the second part of the test but they said no. 

    My doctor believes it is the SI joint that is causing the pain. What I really wanted was regular steroid injections in SI joints

  • @Bitzicat did they give you any sedation? I find sedation can compromise the results. For example, you might get 80% relief following the injection but who’s to say the relief isn’t the result of the sedation. IMO I personally need 1-5 days to know if the injection was a success. 

  • BitzicatBBitzicat PhoenixPosts: 68

    No, I was not sedated.  Felt every needle prick  (six of them).

  • I've finally got my first RFA scheduled for January 24th. I'm quite excited for it since nothing else has worked, and the diagnostic numbing test they did reduced about 60% or more of my pain.

    My understanding is that you typically feel worse for about a day or so and can't really gauge the effectiveness on the first day.
    I'm not sure I understand why sedation would compromise the results if you have this in mind?

    I'll report back when I get my first RFA done. I'll likely get another done in another area.
    I'm really interested to hear if anyone has had lasting results or not.

  • I got mine years ago and it helped tremendously in the passing years..well worth any pain 

    My neck on the left side where it was done is still good, permanent head ache is low and usually tolorable.

  • I’ve had quite a few RFA’s both lumbar and cervical since 2012. Apparently this should be done awake with local a anesthetic or somewhat of a twilight sleep. Well I wasn’t so good at that the first time so subsequent procedures I was given propofol via IV. To be very honest with you, in the beginning it was amazing. My pain was dismissed by a good 80% but as the years went on the procedures became less and less effective. Not by the pain percentage but the length of time I was pain free. Example the first one lasted about 14 months then it went down to a yer then 6-8 months and so on.. you get the picture. Again everyone has different experiences and that was just mine. To say for the immediate future I think they’re okay but for the long term it’s just how your body reacts to it. Btw, it’s good to do physical therapy in conjunction with any procedures if your able. Medicine is just one half of the equation. Putting your hard work in is the other. Good luck!

  • Thanks for the replies.

    I definitely plan on doing PT after the ablation. I'm really hoping it will help rebuild and strengthen my back and core and that by the time the nerves fully regenerate, I'll be in less pain.... time will tell.

  • jbowerjbower wisconsin Posts: 158

    The problem with this is in order for it to work they have to hit the right nerve that is causing the pain.  They try in the general area your pain is but there is absolutely no way for them to know which nerve or group of nerves to hit.

    They did 6 injections on both sides and I felt every single one of them because I didn't want sedation.  They started with the left side the first Thursday and the right side the following Thursday.  Unfortunately the nerves they burnt were not the right one's for pain relief.  

    My insurance said I had to wait 3 months before they can try it again.  I decided not to try it a second time.  Too much of a guessing game to go through that.  I didn't have much pain afterwards but I definitely felt it while they did them.  A lot of pressure and some pain.  It was more uncomfortable than anything.

    I wish you the best of luck on yours and I hope they get the right nerve.  My doctor said if it did work then usually it was 9 to 12 months of relief.  Since the nerves grow back it is too hard to know what will happen.

  • Just a quick follow-up - I had to reschedule my December procedure because I got sick (and the surgeons won't do this procedure if you have even a slight sniffle).  So I'm scheduled in two days.  Will report back (again).  Keeping my fingers crossed.

  • Best of luck and hope you get better!

  • Yes. I experienced great pain relief form RF Ablations for 7-8 years. I would get, on average 8-10 months of notable pain relief before being in need of another. I received them on both sides of my spine to address degenative  spine at L3-S1. After about eight years, I experienced the first failed ablation. 

    I was disappointed and surprised. I learned from my pain management physician that eventually, our spinal nerves become conditioned to the ablative procedures and "change tactics" to reroute their respective neuro-transmission signals. Our nerves have a sort of nominal intelligence in this regard. Epidurals and ablations amount to our attempts to "outsmart" our bodies. Our physiology responds with its version of "improvise, adapt and overcome."

    Hope that helps. It was a good eight years, however. If you're new to a neuromuscular chronic pain, this may be a very acceptable proposition (eight years of relief before having to consider other options). 

  • Good afternoon!  I too have had lots of luck with RFA in my low back - SI areas.  They last me about 8 months and are amazing once the nerves die off. I still experience some pain for a few weeks. I have also had cervical RFA but without any luck. Yes, the doc must get the "right" nerve but that is why you have 2 diagnostics trials first. I hope you get great results with the burning - it can be a life-changer for some people. Best of luck to all!!

  • Thanks Chris and everyone else. These are some encouraging stories.

    Yes, I had a diagnostic injection that seemed to relieve about 60% of my pain or more, so I am hopeful that the ablation I just had done in that area will provide some relief.

    I understand it varies from person to person, but I'm wondering how long it took for most people to feel the relief? It's only been two days since my ablation, so I'm still in a decent amount of pain. I'm also feeling a little weak and depressed, but it's hard to tell what that's from, as I recently went through a breakup due to my partner not being able to cope with my pain and situation.

    It has been a rough time.
    I'll report back when I start feeling some relief. Best of luck to all.

  • I've had RFA done about 6 times. last 2 times both sides done at once but it's painful even under twilight sedation. I always had it done under live x-ray and IV sedation, although I feel everything. I get a lot of relief lasting a year up to 2 years. 

    It's painful for the first few weeks for me so was told to put ice on like every hour a few minutes the first few days. I'm with a Pain Management Dr. in a hospital and took about 8 months to get in initially to see him.. RFA is the only thing that kills the burning horrid pain from facet joint nerve pain for me as well as pain meds. 

    I hope you get some relief. Charry

  • Thanks for the information, Charry.

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