3 weeks post rhizotomy - is there still hope?

[beka]

Hi everyone

I had a facet joint rhizotomy (nerve ablation) done to 6 levels of the left side of my back, t10 - l3. It was 3 weeks ago today.

For the first 10 or so days I had a lot of soreness from the procedure, but it felt like my 'normal' pain was less.

Since then, I have my normal pain, and then some.

I know there's been discussion on rhizotomies before, and I know that it can take 4-6 weeks to get results. But what about until then, is it to be expected to have extra pain up till that point?

The pain is predominanty where I usually get pain, but covering a little more area, and it's still pretty intense. I knew the relief was not likely to be complete at this stage, but did think I'd be feeling some relief by this point. Could it mean the nerves have not been properly ablated?

Thanks for any and all replies.

[mmglobal]

how convincing were the diagnostic injections prior to the rhizo?

Did they successfully identify levels causing pain? 5-levels, both sides... that's a lot of rhizo. Please describe the process that got you there.

Welcome to the forum! I'm glad you found us, sorry you need to be here. I hope we are helpful and that you ultimately find some relief.

Mark

[beka]

Thanks for the quick reply, Mark, and thanks for the welcome.

I responded pretty favourably to some medial branch blocks before the ablation (only about four hours of relief, but it was noticable and apparently that was enough for the doc).

In addition I've had symptoms (for many years) consistent with facet joint probs -- pain on leaning back, twisting, and pretty much anything static for more than about 20 mins, with the exception of lying down.

I had just the left side done as my right side is pretty much pain free. Yeah, a lot of levels I know. I don't know whether or not that affects recovery time.

[mmglobal]

Most of these types of injections I've seen and discussed with many doctors have 2 components. Short acting local plus a steriod component. The local should bring very fast relief and only last a few hours at best. The steriod might not kick in for a couple of days, then may last many days or longer.

In my case, both worked well, but with the increased functionalty brings increased activity and the possibility of setting myself back. (I think this is pretty predictable in most people. It's difficult or impossible to stay in jail when the door is open!)

R your facets bad on MRI? I don't know if the pattern of relief can be from steriods injected during the ablation? increased pain from incomplete ablation? Again... I'm just thinking out loud here and could be completely off base. Let me know what you think.

Mark

[beka]

Hi Mark

In my case there was no steroid used, I'm sure of that because I asked. Just local at the time of ablation.

I've heard that some people get relief either instantly or within a few days of the RFA. I know in at least one of those cases steroid is used and I wonder if that is the reason -- it's actually the steroid giving the relief while the ablation takes its course.

Only one set of facets (L3) showed as hypertrophic on scans. But then I've read quite a bit that scans aren't reliable for detecting symptomatic facets and hence the other diagnostics?

Now at 23 days some of the 'worse' pain is abating, but no significant relief yet. Don't know what to make of it but the waiting can really mess with you.

Wonderful that you've managed relief with the shots.

[beka]

I'm going to try this again because there's just not that much discussion on rhizotomy around the place and I've noticed that there has been a bit here in the past.

I am getting pretty concerned now. I am at 4.5 weeks and am still hurting as much as I was 2 weeks out. My skin feels sunburned (looks normal, and feels normal to the touch) and I'm needing extra meds. I feel no relief whatsoever, only more pain.

I know I need to wait 6 weeks to judge, but I just really don't know what to expect in the meantime.

My dr has been hopeless in preparing me for this and i won't have contact with him again till March 17.

I guess my worry now, more than whether or not this can still be a success is whether this procedure can cause long term or permanent worsening of pain. Has anyone heard that? My doctor told me the effects were 'reversible', making me feel, well, why wouldn't I try it? He does a ton of these procedures, but as for what his sucess rate is, I have no clue.

Anybody?

Thanks

[mmglobal]

Beka, I'm sorry that you are having such a rough time.

Are you certain that the sunburned feeling is related to the ablation? Could there be some other issue that is ramping up nerve pain? My guess is that you'll be stuck waiting it out. If you are worse after the ablation, you'll be asking your doc about the potential effects of partial ablation.

Please remember that while I've experienced a remarkable recovery, my first injections were in September. After that I was a 100% shut in. More injections in November.... still a shut in. I started to improve at the very tail end of December. Another set of injections in Jan... then in February, remarkable improvement.

We'll never know if it was due to injections or time or both.

Wishing you all the best...

Mark

[ans]

I wish you well Beka. I will get rhizotomies sometime for my facets and S-I joint.

Hoping this "kicks in" and that you get the relief you need; you've suffered enough to earn it!

My best, Allan

[Chris G]

Mark-

At what levels did you have your injections?

[mmglobal]

Chris... first set was T2-8. 2nd and 3rd set were T6-7-8. All are false positive for facet pain, I believe now.

[mmglobal]

beka, any progress?

[techgurl1988]

Anyone reading this from Google search like me, I just wanted to point out that the burning sunburn feeling is something the doctor should know how to take care of and is so,etching that can happen if they hit the wrong nerve. My doctor actually warned me about it and told me to take home some lidocaine patches each time I had it done. Luckily it never happened to me.