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Nerve burning for pain
Surgical techniques used for use in back pain: nerve burning vs blocking and risks involved. Mostly concerned with the nerve burning for back pain risk vs results.
Nerve blocks and ablations are not surgical techniques, but interventional pain treatments. They require no cutting, involve no bleeding or tissue damage. They are similar to injections.
Nerve blocks are performed on a specific afferent nerve plexus that carries pain signals to the spinal cord, and from there, up to the brain. Blocks are done with a numbing agent, like Lidocaine, and are temporary solutions. They are used generally to diagnose or treat ligament disease. Usually benefit is achieved with 6 injection treatments, however, some practitioners continue to inject even if no measureable benefit is achieved. This kind of doctor gets a reputation as a "shot jock" and should be avoided.
Certain nerve block techniques involve the injection of noxious agents to destroy nerve tissue. These offer a longer term relief from pain, however, peripheral nerves regenerate at a rate of approximately 1cm/year, depending on age, and blocks must be repeated.
Neurolysis or "nerve burning" is another non-surgical technique to destroy afferent nerve tissue, Today it is usually done with electrical energy applied at a frequency in the radio band, so the procedure is known as pulsed radio-frequency nerve ablation or RF ablation.
RF ablation is done under fluoroscopic guidance while the patient is mildly sedated. One particular RF ablation procedure, neurolysis of the medial branch nerve, is a popular treatment for back pain due to facet syndrome in both the cervical and lumbar spine. Pain from arthritic facet joints are blocked when the afferent nerve providing sensory innervation, the medial branch nerve, is destroyed.
The procedure is simple -- cannulas are applied to the area, under fluoroscopic guidance, until they come in contact with the afferent nerve against the vertebrae in question. The cannula is then secured in place, and an RF probe is inserted down the center of the cannula(s). After a test current is applied to check proper placement, RF current is applied for up to 4 minutes to lyse the nerve(s). The probe and cannulas are then removed, the sites cleaned and bandaged. The patient is removed to PACU, recovered within 20 minutes, and sent home within an hour. Rest and the application of ice packs to the sites are recommended for the first 48-72 hours, and then the patient can resume his/her normal activities. While some pain is common during the first few weeks post procedure, patients are usually back to normal within a month, without the pain of spondylosis.
Conventionally, RFA procedures are done in two steps -- first one side, then the opposite site of the spine.
Risks are minimal when the procedure is performed under fluoroscopic guidance, in a proper procedure room under sterile field, with an experienced practitioner placing the probes. Risk is a little higher in cervical RF ablation because of the space limitation and the angle of the facet joint, but risk is lower n lumbar procedures as the afferent nerves are distal to motor neurons.
When I say risks are small, I mean less than 1% chance of unintentional nerve damage, bleeding, or infection.
RF ablation interventional procedures are greater than 90% effective in reducing facet-joint related low back pain.
However, low back pain can be complex process involving joints, discs, ligaments, nerves, and cord compression. Because of the complex nature of LBP, RFA rarely removes all LBP, but is effective in reducing LBP up to 50% in many patients.
Because of nerve regeneration, RFA must be repeated in an average of 250 days, however, my last lumber RFA reduced pain for over 500 days before I needed a repeat procedure.
Interventional pain physicians who perform the RFA have greatest chance for success after completing approximately 700 procedures.
Best of luck.
Nerve blocks are performed on a specific afferent nerve plexus that carries pain signals to the spinal cord, and from there, up to the brain. Blocks are done with a numbing agent, like Lidocaine, and are temporary solutions. They are used generally to diagnose or treat ligament disease. Usually benefit is achieved with 6 injection treatments, however, some practitioners continue to inject even if no measureable benefit is achieved. This kind of doctor gets a reputation as a "shot jock" and should be avoided.
Certain nerve block techniques involve the injection of noxious agents to destroy nerve tissue. These offer a longer term relief from pain, however, peripheral nerves regenerate at a rate of approximately 1cm/year, depending on age, and blocks must be repeated.
Neurolysis or "nerve burning" is another non-surgical technique to destroy afferent nerve tissue, Today it is usually done with electrical energy applied at a frequency in the radio band, so the procedure is known as pulsed radio-frequency nerve ablation or RF ablation.
RF ablation is done under fluoroscopic guidance while the patient is mildly sedated. One particular RF ablation procedure, neurolysis of the medial branch nerve, is a popular treatment for back pain due to facet syndrome in both the cervical and lumbar spine. Pain from arthritic facet joints are blocked when the afferent nerve providing sensory innervation, the medial branch nerve, is destroyed.
The procedure is simple -- cannulas are applied to the area, under fluoroscopic guidance, until they come in contact with the afferent nerve against the vertebrae in question. The cannula is then secured in place, and an RF probe is inserted down the center of the cannula(s). After a test current is applied to check proper placement, RF current is applied for up to 4 minutes to lyse the nerve(s). The probe and cannulas are then removed, the sites cleaned and bandaged. The patient is removed to PACU, recovered within 20 minutes, and sent home within an hour. Rest and the application of ice packs to the sites are recommended for the first 48-72 hours, and then the patient can resume his/her normal activities. While some pain is common during the first few weeks post procedure, patients are usually back to normal within a month, without the pain of spondylosis.
Conventionally, RFA procedures are done in two steps -- first one side, then the opposite site of the spine.
Risks are minimal when the procedure is performed under fluoroscopic guidance, in a proper procedure room under sterile field, with an experienced practitioner placing the probes. Risk is a little higher in cervical RF ablation because of the space limitation and the angle of the facet joint, but risk is lower n lumbar procedures as the afferent nerves are distal to motor neurons.
When I say risks are small, I mean less than 1% chance of unintentional nerve damage, bleeding, or infection.
RF ablation interventional procedures are greater than 90% effective in reducing facet-joint related low back pain.
However, low back pain can be complex process involving joints, discs, ligaments, nerves, and cord compression. Because of the complex nature of LBP, RFA rarely removes all LBP, but is effective in reducing LBP up to 50% in many patients.
Because of nerve regeneration, RFA must be repeated in an average of 250 days, however, my last lumber RFA reduced pain for over 500 days before I needed a repeat procedure.
Interventional pain physicians who perform the RFA have greatest chance for success after completing approximately 700 procedures.
Best of luck.
I am scheduled to have my right side nerves burned tomorrow, then in 2 weeks I return to have my left side nerves burned. I have done some research because I am basically out of options. I have been living with pain for almost 13 yrs. I have had several surgeries, procedures, nerve blocks, pain pump, electronic stimulator, several different injections. I have only gotten worse and in excruciating pain every day. I am a little nervous but I need some relief. Do you or anyone else reading these that you may know have any insight on the Back Nerve Burning? I would appreciate any help or comments on this. I need pain relief and I have run out of options. Thank you!!!
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