Back pain: My Radio Frequency Ablation Success Story

[AZRickD]

It's early in the game, but here it is so far:

http://www.youtube.com/watch?v=9xPKpi0ILJw

I have been dealing with an ever-worsening lower back (lumbar) issue since high school and college wresting. Add dirt bikes, hang gliding, lifting, mountain biking, and running and doing stupider stuff like lifting 150-pound hitches, and you'll get an idea of the things I've done to my back over the last 30+ years since my first back lock-up. 30 years of chiropractic, ice-packs, three MRIs. No aggressive treatment or surgery such as disc trimming.

Over the summer my back locked up for four straight months. Usually it would only go for a week or two. Too many sessions hunched over working on the Gasser or moving furniture, with not enough ice-pack and/or rest.

My chiropractor sent me over to a "pain management center" where they specialize in RF Ablation. One has to qualify for it (insurance). If the lock-up and pain is being cause by, say, a herniated disk that presses against a sensory nerve to the muscle causing it to spasm, you qualify. The test is for them to go in with lidocaine to shut down the nerve. They did this from L2 through L5 on both sides. Eight injections. You can get a twilight general anesthetic for this test (propofol "Milk of Amnesia), but I elected to go with a local (which made the actual injections feel like I was getting Rolfed).

Test 1 worked. They told me to go about a normal day (office, P90X stretch, a light hike). Six hours of zero spasm. I was standing mostly upright for the first time since June. As the lidocaine wore off I was expecting the worse, but it felt pretty good. A few days later I did touristy things during a visit in San Francisco and tied my back in knots.

So now they do Test 2: A week later (two days after SanFran), the repeated the lidocaine procedure. They told me to give it a good test. So, I went straight home, put on my running shoes and fast-hiked Thunderbird Mountain in north Glendale, Arizona -- a 600 foot pile of volcanic rock with a well-worn trail. I hadn't done this in a year. No pain (either up or down) and a satisfying 160bpm heart rate. And it stayed nice and loosey-goosey for about four days. Yay. I qualified.

Did the right side first (my worst side). The left side would have to wait. Protocol. I had read all sorts of horror stories about RF Ablation. But these were coming from people with histories prior failed back surgeries, or fibro-myalgia. This didn't apply to me.

I woke up from the propofol (short half-life). All numbed up, I bent over to tie my shoes. As the local anesthetic wore off, I felt some pressure on my right side, but nothing a day's worth of ice didn't take care of. I didn't use ibuprofen until bed time.

Results: It worked pretty well. The doctor was able to zap three out of the four nerves nicely. From the forth nerve, I still get a signal from that nerve when I lean over to the right an extreme amount. But I recover within seconds.

After this, I spent an hour changing tires on my WR450 dual sport. All hunched over. My back was abused and it was tight, but it didn't lock up. I recovered after a day. Normally this would've taken a week or more of daily ice and ibuprofen.

On Wednesday I had my left side (minimal involvement) done. I felt very little pressure at the injection sites (four, again). Unlike the last time, it took me over a day to recover from the last remnants of the propofol.

The doc says no stretching for a couple of days.

This procedure is not a cure-all. First, while it isn't as effective as lidocaine, it should last for several months (6, 12, 18, 24?). I won't know until I feel the nerves re-engaging as they heal. If you're 25, they heal up faster. 52? slower. If I'm Joe-Average, it should last a year or so. Then I go in for the RF Ablation again. Prior success is predictive of future success in this case.

Second, I have to make sure that I don't do too much stupid stuff. I always ride with an elastic back brace. And on top of that, I have a more expensive brace that has a little block-n-tackle mechanism to really cinch it up. I have to do light stretching, take care not to stand weirdly bent over carbs and tire changing stands, and all the rest. I have an inversion table which I use at the beginning of each day, when I get home, and before I hit the sack.

Let's see how far this takes me.

[andoman]

I know its no laughing matter, but this line in your post cracked me up. Just about fell out of my chair:

Originally Posted by AZRickD

I have to make sure that I don't do too much stupid stuff.

I also laughed that the narrator's first words in the video were: "In elderly patients...."

I'm sending some encouragement your way and hope that this treatment provides a workable long term solution to the issue. Hang in there!!

[AZRickD]

My wife shares similar sentiments.

[jgas]

I have had all the same stuff you mention and add in 2 surgeries for partial disc removal due to ruptures. I get regular steriod shots from the VA which help, but all they are really doing is preventing further damage. But I'll take any help I can get. I am a good candidate for RFA on the left side which has not had surgery yet, but not on the right side which is my most painful side.

They are talking about putting in a permanent radio implant of some kind which stays in and works all the time, but then they caution me against strenuous stuff like riding. So far I prefer to ride and be miserable. This dirt bike stuff is like a drug, it got me addicted at age 6!

Good luck, and keep us posted as time goes on. I may try RFA eventually.

[AZRickD]

Everyone is different. There are so many things going on with a spine not to mention how it was injured (over time vs car accident, for example).

If the cause of *some* of your discomfort is your ruptured disc pushing on a sensory nerve, the lidocaine test will give a good indication.

My doc said some insurance policies (mine, for instance) are going away from paying for steroid injections because they don't last long enough. Heck, a couple months of relief is better than zero months of relief.

Keep fighting.

[flybars]

I sure hope the RFA works well for U. Sounds encouraging. I've been dealing with back pain since 1972. Keep us posted on your progress.

[jgas]

Yep, even the VA doesn't like doing continuing spinal injections due to them not lasting long. Sometimes the doc gets the stuff exactly where it needs to go and it lasts 8-12 weeks, other times it does almost nothing. But I have nothing left at S-1 but scar tissue, no disc is left. Some people get 6 months of relief. Even at best injections only help the pain about 30% anyway, but 30% is huge when you have pain that stops you from doing things or enjoying life.

I had Lidocaine, it helped more on the left side so I may get RFA eventually. Currently they are trying to focus mostly on my right side which is far worse. Something that helped alot but they don't want to do much is Tordol injections. I think Tordol is kind of liquid Ibuprophen? It would help for about 10 days to 2 weeks but it was just a shot in the butt and helped more pain than just the back. I think it even helped somewhat to prevent migraines, but I'm not positive if or why. The migraines seemed to be a bit less severe and frequent with Tordol although that wasn't why I got the stuff.

[AZRickD]

Still doing well.

[AZRickD]

I spent the last three weeks experimenting with not wearing my elastic back support on a daily basis as I had been doing.

This eventually led to a tightening feeling in my back muscles during the last couple of weeks where I have been riding quite a bit carrying stakes in prep for our club enduro (April 14th). I had also made it a practice of icing my back at the sign of spasm previous to this.

As of this week I have added both treatments. The ice helped a bit. The back support works very, very well.

[rgranger]

I was thinking about trying that for my rotator cuff. darn major accounting software upgrade keeps getting pushed back and so does my window for surgery. I had planned on getting it early last summer, then that April go live passed, then the august and october, so here is to April 2013! I haven't been able to sleep. Went to a pain doc, who turned out to only work on spins, so after we both said, "What the Fark am I doing here?", he gave me some Voltaren Gel, expensive stuff but it does help with the pain. some sort of local anti-inflammatory and analgesic. Allows me to get a few hours a sleep at night. so, if anyone is desperate for joint / muscle pain...
Rob
The spin guy also said that it was great for sunburn pain