RFA procedure for back pain

[tomme boy]

https://en.wikipedia.org/wiki/Radiofrequency_ablation

Just in case someone asks. I have not heard of this before. I am scheduled to have testing done to see if this will work. I have had problems for a very long time. My C7 vertebrate is crushed and the disk are also crushed. The actual surgery that they want to do to fuse the area together will put me down for at least 6 months due to other complications of my health and not healing because of diabetes. They would have to split me from my hip to my armpit and remove everything inside to get to the area they need to work on.

I am not having this unless it is a last resort. So, anyone heard of this RFA thing before?

[OeldeWolf]

Very interesting procedure. Are they ablating damaged nerves, for pain control? It looks to be minimally invasive, especially compared to what you say they have to do to fuse the damaged areas?

[MaryB]

They don't split you open to get at C7, they go in through a 1 inch incision in the neck. I just had C5/5 and C6/7 fused a year ago... Any doctor going in through the body cavity is using really really old techniques and I would run.

[tomme boy]

University of Iowa hospital in Iowa city. That may be why. They use everyone as test subjects for the school. But they are the only ones I can see. It's been ongoing sense 2011. Seemed all they wanted to due was give me more pills to turn me into a zombie. I feel out of the shower when I passed out this spring. And have passed out 2x'so sense then. All from the drugs.

I am going down hill fast. I can not believe how my other half is still with me. I have turned into a very angry person due to the pain. Mary, You have been there so you may know what I speak of.

Tuesday is going for trigger finger release surgery on the ring finger and index finger on my left hand. Then Thursday I go for the shots that they due to find out if the rfa will work. The way they work there it will be spring before they actually do the procedure.

[tomme boy]

Mary, how has the fusion worked out

[shoot-n-lead]

Prayer sent for some relief.

[leadman]

I have had 5 or 6 sets of RFAs done on my C spine. My disks are worn and the medial joints on the sides of the vertebra hit together and pinch the nerves. They will do a block first and if it works the RFA. They have worked for me but the nerves may regenerate like mine do. Not a fun procedure but have had worse, like when I woke up when they were cutting out my thyroid!
I have backed off on things that tense the neck muscles for a long time as this tends to accelerate the return of the pain. Looking down when I am working the press is not good for me, or lifting heavy weights too much.
Good luck and hope it works out for you. Also ask them to put the ground pads on your lower back, not in your calves. For some reason my doctor changed the location and it increased the pain felt during the RFA. Might be because of the longer path and more resistance for the electrical current to travel.

[MaryB]

Only had the neck done so far and that was instant pain relief plus instant return of feeling in my left arm. And no more dropping stuff all the time.

And I live in constant pain, some days worse, some days better. After 10 years I no longer think about it and just go about my daily routine. Unless it is a super bad day like pulling a back muscle last week... still recovering from that! On top of the back issues I have torn rotator cuff in the left, carpal tunnel left wrist, bursitis in the right shoulder after 2 rotator cuff surgeries, bad right hip(bone spur pressing on a nerve), and torn ACL's in both knees...


Mary, how has the fusion worked out

[Lloyd Smale]

Ive had a number of back surgerys. So youd think that having had more then one on the same problem id be against it. Bottom line is in the big picture I'm much better today then I was before this mess started. All the other "bandaid" fixes were just that. Ive had the shots the acupuncture gone to the chiropractor, all of it. You might get some small relief for a few days or weeks but it doesn't fix anything. My dad was told about two years ago he needed a fusion. Hes 84 now and his argument was he was just to old to get any good time out of it and recovery and therapy would be brutal. I talked him into it finally and for the first time in 4 years hes actually out getting ready for hunting season. His back pain is about gone. By gone I mean he can live with it. Some think it will magically shut off all pain. Ive had 4 back surgerys, an ankle replacement and a hip replacement and what you do get out of them is quality of life. All three still have SOME pain. More soreness and stiffness then pain but I can get up in the morning and get moving and an hour later I can most times even forget the pain is there. No more popping narcotics like M&Ms! For about the last year I can get by with taking narcotics about an average of once a week rather then 6+ times a day!

[leadman]

The RFA treatments have kept me going for about 9 years now. I'm like MaryB though, constant pain, 31 surgeries for various things, right knee is bone to bone, severe arthritis with lose of 4 joints, both thumbs and right great toe. Narcotics every day but these are starting to fail to control the pain.
So it is all in how much pain you have and how it effects your daily life. You can get the block, then the RFA, if they don't work then you can still get the surgery. The down time with the RFA is usually a day or 2, not so the surgery. I only have one operational vocal cord and the surgery is hard on them as they go in the front so do not want to risk damage to the other cord.

[MaryB]

They have done lumbar decompression where they removed bone spurs and shredded disc to make space for the nerves, helped some for 6 years then I started downhill again.

[tomme boy]

Soreness and stiffness I can handle. But the waking up in the middle of the night throwing up because it hurts so bad is putting a major toll on me and the misses. It affects her just as much to not be able to do anything to help me. It puts just as much stress onto her and I do not like that one bit. She does not deserve this. I am praying for something to get better.

[RogerDat]

I have a co-worker who had what I think was RFA, they burn out his nerves to manage the pain since they can't really fix not having any disk left to speak of. He also has a pain medication that is not narcotic, he had to kick an opiate addiction because he couldn't work stoned. This medicine he dissolves under his tongue when needed and gets rapid relief. He is back riding a motorcycle to work again so between the RFA and that medication it really works for him.

I am trying to get an appointment with his doctor, my doctor suggested steroid shots but since the problem is worn disk(s) and nerve getting pinched it seems unlikely to "heal" with the shots. I think it is important to have a doctor that can handle all the methods of treatment from surgery to RFA to shots so one does not get passed from pain clinic to RFA doctor to surgeon.

[shoot-n-lead]

My uncle and a co-worker had the RFA done, to good effect.

[Jesse Heywood]

I think you're confused on which vertebra. C7 is the bottom vertebra in your neck. C is for cervical. The next part is the thoracic, chest which go T1 to T12. T7 would be just below the heart. Then is the lumbar spine, the low back, L1 to L5. Lower is usually called the tailbone, where the bones are fused at birth. Ask your doctor, nurse or therapist.

The surgery described is usually for the lower back, where your intestines are laid aside and they place a mesh cage around the vertebra and cement things together. A friend had that done several years back and it has worked. He had to lose weight before they would operate.

I had not heard of the RFA until this post.

[tomme boy]

C7-L1 is how they labeled it in the MRI and xrays. Must be the range they took. Just below the shoulder blades up to the center of them. This is where it is messed up the most. Hence the reason of having to lay everything out during the surgery. I don't know what all the parts of the spine are. I tried looking them up but got more confused.

Time to leave to go get hand looked at for a trigger finger release surgery in a little bit. Already had 2 done on right hand. Now have to have the same two fingers done on the left.

[Blackwater]

I've had some surgery on back & neck, and haven't heard of that particular surgery. Sounds awful, and something good to stay away from if you CAN. It's that "can" part that's the key, IMO. Many of us here have dealt with all sorts of back and cervical problems. And I went for over 30 years limping along, because docs back then were really just learning how to do these surgeries. They're now really great at most of them, barring too many complications, which are always a joker in the deck.

But in all of it, I think that the rule for submitting to ANY type of surgery is to wait until you KNOW you HAVE to have it. I was told that 30+ years ago when I hurt my back initially, and that "when it's necessary, you'll KNOW." That was the best advice I ever got! And I think it's the best guideline a layman can have with regard to any surgery, minor, major or plumb scary. That's just MHO on the matter, of course, but I thought it was good enough advice that I'd received that I figured it might be helpful to you. I wish you well, and will pray for you, and that you make a good decision when it's due, and that the results are great in the end. That kind of surgery is a real poser, but it beats suffering heavily the rest of your life. No guarantee it won't cost you that life, of course, but that's true from even having a tooth extracted. But the odds are in your favor, usually. Ultimately, it's really just a value judgment, and when the pain gets unbearable, and you just can't tote the load, it's time to git-r-done, and trust the results to God. Again, just MHO. Hope it helps?

[farmerjim]

They do a nerve block to test if the RFA will work. If it does ( the nerve block only works for a few days) They do the RFA. I have had 2 in my lower back. Last years is still working and the one from 3 years ago is starting to hurt again so will need to be redone. I went to the pain doctor yesterday for my neck. It is just bad arthritis this time They will do a nerve block and then a RFA if the block works. I just have to find the time to go in to have it done. Between the wife and I, we have 6 Dr. appointments that requires a driver this month. I had the neck fusion like MaryB 5 years ago. They go through the front of your neck to get to the vertebra. In the hospital only one night. The bad part is having to wear a cervical collar for 6 weeks. I have had 2 lumbar surgeries. they are much worse than the neck.

[RogerDat]

One of the things my co-worker told me his doctor said stay away from anyone that wants to do cage or mesh surgery. Said it is extremely old school, not as effective and much riskier than other options. For clarity the mesh thing was stated as a really bad approach.

[MaryB]

My neurosurgeon does lumber fusion from the back. Not many take all your insides out anymore, that is a very old method.


I think you're confused on which vertebra. C7 is the bottom vertebra in your neck. C is for cervical. The next part is the thoracic, chest which go T1 to T12. T7 would be just below the heart. Then is the lumbar spine, the low back, L1 to L5. Lower is usually called the tailbone, where the bones are fused at birth. Ask your doctor, nurse or therapist.

The surgery described is usually for the lower back, where your intestines are laid aside and they place a mesh cage around the vertebra and cement things together. A friend had that done several years back and it has worked. He had to lose weight before they would operate.

I had not heard of the RFA until this post.

[MaryB]

My neurosurgeon doesn't believe in the collars! Said it weakens the muscles to much and makes recovery take longer. I was in overnight, told to not flex my neck to much and booted out. No PT after, just use my neck as normal after 2 weeks to let the porous plastic/bone matrix insert start fusing to the vertebrae


They do a nerve block to test if the RFA will work. If it does ( the nerve block only works for a few days) They do the RFA. I have had 2 in my lower back. Last years is still working and the one from 3 years ago is starting to hurt again so will need to be redone. I went to the pain doctor yesterday for my neck. It is just bad arthritis this time They will do a nerve block and then a RFA if the block works. I just have to find the time to go in to have it done. Between the wife and I, we have 6 Dr. appointments that requires a driver this month. I had the neck fusion like MaryB 5 years ago. They go through the front of your neck to get to the vertebra. In the hospital only one night. The bad part is having to wear a cervical collar for 6 weeks. I have had 2 lumbar surgeries. they are much worse than the neck.

[WFO2]

Double fusion here 5/6 6/7 bracket inserted through the front . Hard to talk for a week or so and had to wear a C collar for 90 days straight .Long story short still have pain and getting steroid shots quarterly and RFA's once a year . Hope it turns out better . Had a kidney stone last week and found out I have a Triple A . Guess years of hard work are catching up to me . Good luck .

[tomme boy]

Well I went for the first test shots and they only lasted for a couple hours. Have to call in the AM to let them know about how it worked.

I will tell you what, they were poking around trying to find the nerves and they hit the one that is causing the problems. I about jumped off the table. Doc said he knows it sounds bad but that was the reaction that he wanted. It shows him that tha was the one causing all the problems. So we will see what happens next

[tomme boy]

Well an update. I had the two sets of injections for the test to have the RFA done. The first set gave me 50%+ relief. I also has major muscle spasms going on at the same time so judging the relief was hard. And the second set gave almost 100% relief. I have not felt like this for 20 years. So the procedure was ok'ed and scheduled for yesterday.

This Monday I received a call from the Dr's office telling me that the surgery was cancelled as the insurance company said it would not pay for it. But they still wanted for me to come and talk to the Dr. So meeting with the Dr. yesterday he tells me that the insurance company wanted a peer to peer meeting with him. He goes onto tell me that they say that the % of relief I got was NOT enough for them to say it was worth it. And he goes on to tell me that the Dr. he is talking to on the insurance side is an obstertrician! I did not think I was having a BABY???? My Dr. is pissed! he can not believe that they would let someone like that make a call on how he would do this. He says that most insurance company don't know how to deal with the type of injuries I have.

He goes on to tell me that he showed them that I have the worst case he has seen in 10 years of an injury in this area of the spine. He tells me flat out it is a case that the insurance company is handling this through medicaid gets payed more to DENY stuff. The more they deny the more they get paid.

SOOO it is up in the air right now as to what I am able to do. He tells me the only thing we can do is to repeat the test in a few months and try again.

Anyone know how I could make a formal complaint against the INS Company? I am not going to let this rest now. Last week they denied a request for some pain killers for when I was passing kidney stones. and now this! I am not a happy camper right now!

[MaryB]

How to file a complaint in IA http://www.iid.state.ia.us/market Are you on medicaid or medicare? Huge difference!

[tomme boy]

Medicaid till my SS is approved. But I'm not holding my breath for that one either.

My Dr was telling me about how he can not believe that I am not on SSD. He told me he sees people all the time that he knows that they are faking problems and are on it. But he also has LOTS of patients that can not get it and are in really bad shape.

I am so fed up with ALL of this. Things have to get better than they have been this past year.

[WFO2]

I get them for C6/C7 they keep me going . For me the first day after is not so good but it keeps me working .

[Blackwater]

I'm thinking that the above posts in doubt of the necessity these days of such invasive surgery for a disc are likely correct. I think at the very least, I'd see another surgeon for a 2nd opinion. I have some VERY good docs, who've saved my life, literally, but I STILL question even those! It's just good judgment on the patient's part. And with all the back surgery being done via smaller and smaller incisions, it'd really be foolish to NOT seek a 2nd opinion, and I've been watching these matters for well over 30 years now, and FWIW, the neurosurgeons seem to do a significantly superior job to what the orthopoedists tend to. I had my last surgery for disc fusion done, and I did NOT take ANY pain meds after the surgery! I'd had some really bad effects from the pain meds, and what pain there was after the surgery, was bearable, and I was still drowsy, so mostly just slept it off. I had a really great doc, and the newer proceedures seem to definitely be a vast improvement as to how invasive the surgery is, beneficial results, and healing time. I was up the next day on my feet! Quite a difference from what you're describing, Tommy, so I'd really, REALLY want a 2nd opinion, and from the best neurosurgeon I could find! There have been vast improvements in techniques, and most importantly, in RESULTS in even the last 5 years. Those docs who've kept up with it all can really do miracles! That's FAR too attractive a 2nd chance to miss!

[tomme boy]

The reason for this procedure is to prevent from having a actual surgery. It is a needle that heats up and burns the nerve so that the pain signal is blocked. It is more of a band aid than anything as it is just blocking the pain signal. The actual damage is still there and may be getting worse.

Where the damage is mostly at is right up against the lungs. They would have to be deflated and moved to be able to get to the location of the most damaged areas. You cannot get to the area from the back like most people think by a little cut.

[MaryB]

T10/11 for me... but only if I stand in one spot to long.

[44man]

Darn fellas, I pray for you all. That sounds scary as all get out. I can tell you how to get disks fixed without surgery but bone damage is another thing.

[Glassman66]

I feel for you guys and gals, I too am in this mess. C5/C6 fused with bone from my hip, just got my second knee replaced and my back is a mess.

Nobody has any idea just how much pain we endure while still trying to put a smile on for the rest of the world!

I have done the same as everyone else, chiropractors, shots, etc.

I have had 3 surgeries since July 1st and the pain meds work less and less. Finally off the good stuff and back to my normal meds and daily pain. Seems like its easier to hurt some and take normal meds than try and take the stuff that gave me all kinds of terrible side effects.

Nice to be able to share with people that understand!





Randy

[mold maker]

Ouch, my neck and shoulders, back and legs. I remember when it was only others, that were a simple PIA.
mm

[tomme boy]

Here is a new one from my primary Dr. He will not prescribe any type of narcotic pain killer anymore as he and the hospital are afraid of losing their licence for giving medicines. He said that the FEDS are cracking down on Dr's to not give them out anymore. Soo..

[Blackwater]

Tomme, if your doc and hospital are letting the Feds rule them, I'm thinking they've been trained in the Harvard MBA Wannabe method of mgt., and that would scare the livin' daylights out of me!!!!

I really believe I'd seek help elsewhere, and see what others say, and I'd DEFINITELY go to a bigger city, no matter how far it was, and see what their best docs have to say. And don't throw darts at the phone book to pick which doc you go to, but check them out on the 'net, and compare and contrast the attitude and character that each one's site seems to display. Then pick the most "professional" sounding one, that advertised "minimal invasive surgery," and check them out.

Surgical techniques very VERY WIDELY now, and the better surgeons seem to use the least invasive techniques these days. Like all other generalizations, that's not always true, but when you have to bet on which ones to choose, it's the best way I know of to search them out and choose. And you can do it all on the computer. And FWIW, in my experience, and many who I've talked to, I'd definitely pick a neurosurgeon rather than an orthopoedist do work on me again, if I ever need it. I couldn't believe how "easy" my experience with my 3 spinal surgeries have been!

Any time a doc wants to filet me like a fish, I KNOW it's time to go get 2nd and 3rd opinions! Now that this kind of filleting isn't necessary any more, it'd be foolish to let a doc do it the "old fashioned" way! Just my 2 cents' worth, anyway. Hope it helps?