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Pain after RFA on spine done
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Pain after RFA on spine done

It's been two weeks since I've had RFA done on my lower back.  I'm still in pain but only in the area of where the RFA was done.  I'm seeing my doctor today.  Is having pain two weeks after procedure normal?
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What is RFA?
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Sorry, I thought everyone knew what it was.  RFA stands for RadioFrequencyAbulation.
Radiofrequency ablation is used to destroy the nerves that supply the facet joints in the spine.  These joints are the small posterior joints on either side of the spine.  These joints were determined by my doc to be the source of my pain.  The nerve ablation will effectively destroy the nerve fibers around the joint, which transit the pain sensation from the facet joint.  In effect, supposedly when the "burn" the nerve endings that are causing my pain, there's no reason for me to feel pain anymore.

I just came back from seeing my doc and he said the reason I'm in so much pain is because to get to the nerve endings he had to go through muscle and tendons.  Because I am not one to sit quiet long enough to let things heal (which he never told me to do) I was my own worse enemy.  

So I guess I found my own answer.  I do have to say the only place I do feel pain, and I  have to say it's a lot, is where he inserted the nettles.  All the other pain in my lower back is gone.  If the doctor had been more specific regarding aftercare, I would not have attempted so quickly to drive, shop, etc.  I only gave myself maybe three days to heal before I went on with my daily routine.  Not Good!

Rita

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I also had an RFA in my lower back 4 weeks ago and my pain has increased.  The doctor just told me that I'm one of the few that takes longer to heal.  I took 4 days off work the first week and then had to take off another 2 1/2 days the next week.  I'm still in a lot of pain and can not stand or walk more than 5min due to the pain.  The doctor did increase my pain meds and I go back next week.  Glad your doctor told you why the pain increase maybe that's why mine in worse.  The doctor did not tell me to rest either, they said I could go back to work the next day.
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Wow!!! I won't ever have that done lol. Having open back fusion surgery is bad enough to try to heal from.
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See, Robbie, this is just not right.  These doctors should tell us what is the worse that could happen and what to look out for.  Instead my doc kept telling me about the ones who had no pain after three days or so.  Naturally I thought that was the norm.   Now it will probably take me twice as long to recuperate.  I'm the type of person who feels guilty if I just sit around without a real excuse.  I told my doc (in a nice way) that I wished he had explained to me how my body would probably react to the procedure.   He said he guessed he should have!??!   A little too late, don't you think?  
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Rita I agree that dr's should educate their patients on every angle of any procedure they are about to go thru so they can be informed and make decisions based upon that knowledge.
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How long did it take for your "familiar" back pain to go away after the RFA? I am three days out from this procedure in my lumbar spine and don't have much  pain from the procedure itself, but I can still feel my "normal" sharp, stabbing back pain and am afraid it has not worked!
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The pain from the procedure did not hit me until at least day 3 or 4.  I think that is because the meds they used to numb the site took that long to wear off.  Then the site pain came on for three weeks,hard and bad.  Suddenly I woke up the other day and the pain was almost gone.  Amazing!  I went shopping yesterday in a big mall and I did have some pain by the time I got home...I way overdid it.  But today everything is back to where it was before I went out.  So I would say a couple of things...first, I don't care what the doctors say - we have to give the site a lot more time to heal than they said. Stay off your feet as much as possible.  If it was done on your right side, don't drive until the pain is pretty much gone. Secondly, we have to use anti-inflammatory meds the whole time along with any pain meds they give us.  Don't be afraid to use them.  The original pain in my sacrum is pretty much gone today.   But for me, it took a lot more time than I was told to get to this place.  So my suggestion is if you should start feeling pain at the site in the next couple of days, don't get upset.  My doctor told me he went through muscle and tendons with the needle to abulate those nerves, so of course there would be pain.  I wish he had told me this before I left the office.  I have a saying I live by..."You can lie to your body but your body will never lie to you".  I would also say if the pain you are experiencing is only at the procedure point and is different than the pain you had before the procedure, it did work, but you won't see the results for a least three or four weeks.  Sorry this is so long but I wanted to share what I've learned. I hope it helps...Rita
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I just re-read your comment.  The pain I felt when the numbing meds wore of did at first feel just like my original pain.  It wasn't until another 4/5 days that the pain settled down to only one spot...where the RFA was done.  But that was after I got totally off my feet and stopped driving.  Before that, I believed what my doc said and went about my daily business two days after the procedure.  That was when the pain came back with a vengence.  

Rita  
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Thank you for your insights! You have been really helpful, and I appreciate your detailed response.

My RFA was a 3-level one done on the left L4, L5, and S1, so I am able to drive, etc. although I have been forcing myself to take it easy. The local lidocaine wore off within about 2 hours after the RFA, and I have been giving myself NSAIDs and continuing to ice the area, which now doesn't feel too bad -- just some local swelling and muscle spasms. I don't mind any amount of pain from the actual procedure because I know this will eventually go away ... it is just that I still feel the sharp, stabbing, "original" pain, and am despondent and depressed that perhaps the RFA may not work for me. I have had this type of stabbing pain for a year and a half with every move I make, and I am so afraid that I will be an "RFA failure," but I guess it is still just too soon to tell -- I will have to be patient for awhile longer.

I will post back with my results as they occur ... I wish us all the very best of luck for a pain-free future.
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Mine was done in the same area and levels.  I also felt the same original pain for at least a good two weeks.  It wasn't until after that that the pain centered in one spot.  I was awake to tell the doctor how the pain felt and to answer a couple of other questions he asked so I know he hit the right spots but I still questioned whether it worked or not. I also was free to drive right afterwards but it really was not a good idea for me to do so, especially being that the procedure was done on my right side.  No wonder I suffered from muscle spasms.  All I can say it's not a fast or easy answer to my pain.  At least not like I was led to believe.
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Dear Rita,

Yes, there is a process for everything, isn't there? I think the guidelines given to the MDs on what to expect are written by people who have never experienced the actual procedure...!

I, too, was awake during my RFA so I could accurately answer questions about whether they were in the right place or not, and also to be sure that no motor nerves were inadvertently being burned -- they offered me light sedation using intravenous Versed, but I declined as based on my past experience, Versed makes me dizzy and anxious. So I had my RFA done just with an intramuscular injection of Demarol with Phenergan (for nausea), but while I was on the table the Demarol kicked in and made me quite nauseous and hot and a little dizzy, so they quickly gave me intramuscular Zofran and turned a fan on above my head and brought me cold washcloths for the back of my neck and hands! This worked great and we carried on -- the Demarol did not agree with me, to say the least. If I have to go through again this in the future, I will just opt for a little Vicodin and call it done.

Anyway, I will heed your wise words and take things slowly this weekend, although I am dreading my return to work on Monday! I am SO glad that your original pain is mostly gone ... you are a beacon of hope.

Hugs,
Anne
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Hi Anne...Hate to tell you but my pain is back again only I think it's muscle pain.  I don't know what to think.  I'm from right outside of Phila and it's hot and humid with thunderstorms predicted tonight.  Could that be the source of my pain?  Who knows. It's not quite as bad as it was but it's still sort of going down my leg.  I'm 75 and maybe at my age it takes longer to heal.  Am I grabbing at straws???  Anyway, Anne, I'd like to ask you a question.  Did you ever take pain meds to block out the pain?  I'm thinking I will need pain management soon if this doesn't work.  Give me the drugs!!! ;-)

Blessings,
Rita
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Dear Rita,

I am so sorry that your pain has returned, and can only hope that it is a resurgence of the procedural pain (i.e. muscle related, not nerve related), and NOT your original pain ... it is possible that with the fall in barometric pressure that is often associated with incoming storm activity, your still-healing soft tissues have expanded and are now swollen and painful. Try lying down with some ice, with your knees bent to help take off the pressure.

As for me, I never took pain meds to block out my pain; I just suffered through. This is not because I am especially brave, but because I needed a clear head to be able to do my job, and also because for a long time I thought my pain was helping to warn me from doing myself even further damage, so I was afraid to try and block it out.

I hope your pain eases soon!

Hugs,
Anne
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Hi fellow pain - bearers.

I found this bulletin board, because I recently had an RFA.  My Doc did 3 levels, L3, L4, and L5.  I had the RFA done 5 days ago, and like several of the other posters, I am still very sore from the procedure.  Before the procedure I had deep low back pain (left side only), hip pain, and pain going down my leg down to my knee.  So far I really haven't felt any different since the RFA, but I'm still hopeful that perhaps it will help long term.

I wish everyone happiness, and the ability to endure the pain.  I have been in pain 4.5 years so I know how hard it is with daily pain. If I have a sudden improvement I will post that.

Boise, Idaho
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I'm two weeks in after my RFA! Right after procedure I was completely numb from waist down on my left side! They did four layers and I was asleep when they did it! It's two weeks and I have my usual back pain plus severe pain into hips and buttocks! Saw dr few days ago and he said I have major spasm going on causing some of the pain and the other from the nerves dying off! Said it will be another 6 weeks probably till this pain stops! In addition to the regular pain meds, I now gave to take muscle relaxers three times a day plus anti-convulsant meds which helps with the nerve pain! Basically knocks you out so you can atleast sleep some at night! Was scheduled for other side but I canceled this for now cause I wasn't told this could happen and take eight weeks total to heal! Six more weeks and they want to do some therapy as all I can really do is lay around! Anyone have a severe case like this??? It is so bad tonight I could just cry all night!
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Thank you for your post.  I just had RFA done yesterday and am amazed I feel this good!  No pain at all except a slight headache last night.  All my usual back pain is gone but I remained wary after reading that so many experience a burning pain of the nerves dying off for about a month.  My doctor DID tell me to just rest for the first 24 hours and no driving.  So I guess I can anticipate the burning in a few days.  Well, OK.  I can take it knowing the pain will be less than before when it stops in a few weeks.  It seems my doctor did something not all docs do.  A couple weeks before the procedure, I went in and he "mapped" the area to pinpoint the correct facets by injecting the needles with a substance he could see on a screen.  No pain meds as he wanted to hear me react as to correct pain areas.  Local injection for needle insertion, but I really felt the substance travel and it was painful.  But I held on thinking of the possible outcome.  I had both sides of lumbar done, maybe 5 injections all together.  Then I kept a pain journal so he could tell when the injection stuff (sorry, forgot what stuff) wore off and the same pain (marking intensity per hour by number) returned.  I think because of that he was exact when I had the actual procedure. I live in hope!
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Hi! It has been a month now after your procedure, what is the current status of your pain? I am interested because I underwent the same last night.

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how long after muscle spasms did you start feeling better ? iam 5 weeks out from rfa
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I had RFA to 8 areas in my lumbar spine 4 weeks ago and my pain is worse than it ever was. Feels like knives are being stuck in my lower back & buttocks. I too was told I could go back to work right after the procedure so like a crazy person I listened to the doctor. Since then I've only been able to work probably 2-3 days out of the week due to the pain. Feel lucky your doctor gave you something more for the pain. Mine just said I shouldn't be having so much pain, refused to give me anything else to help w/the pain (like gabapentin, etc) and told me to schedule an MRI. It'll be another 2wks until I can get that done....so in the meantime, I suffer. I just wish doctors would be completely upfront w/patients about risks & honest (and apologetic) if they think they might have made a mistake and have made things worse. Good luck and keep us posted on how you're doing!!!!
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I am 4 wks out from my abalation (I had 8 nerves done) and am in so much more pain. I was wondering how things turned out for you....
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just to update anyone who might be reading these posts...I started taking gabapentin for the nerve pain & it has improved my pain considerably! It takes some getting used to-at first it makes you feel whoozy & kinda icky, but those symptoms are subsiding. SO glad I finally tried this!
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Wow, I feel so much better having read these posts.  I am one month post RFA to three lower lumbar levels, bilaterally, and honestly thought something just wasn't right.  I truly believed that the relief would have been similar to that of the facet injections but longer lasting. But sadly that has not been true. My leg, buttock and low back pain is still there and I did not even have the overall relief that the facet injections gave me. I too was told I could drive after procedure (drove myself home that day) and only took it easy for about 2 days after, although I iced the area for several days after. Considering what some have posted though I feel lucky that I have had my regular pain and muscle meds in the meantime though.  Hoping this is just a slower process perhaps for a longer relief period in the long run.
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Has anyone had RFA side effects where you have severe muscle spasms to the point it feels like the muscle is ripping off the bone and you actually feel sore after? Almost like your muscle is pulled?
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On November 01, I had RFA done for the third time. Each time the post pain level has differed, from minor to intense. Three weeks of post RFA pain seems to be my personal norm to get relief. When relief comes it's usually fairly quick, after my three week waiting period. This time, day one and two produced very minor pain. On the third day after RFA the pain really kicked in. Day eight, I was almost pain free?? Same routine as ever other day. Today I'm laying in bed in agony. Sorry there are so many people in pain, but I'm relieved to learn I'm not the only one out there. Tomorrow is a new day and hopefully the pain will be less intense. Since I've been through this before I'm fairly optimistic relief is about a week away. BTW in my case relief lasted a little over a year and the full force of my former pain came back a few week thereafter. Good luck to everyone.
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Today is November 15, it's day 16 after my RFA procedure. As of yesterday only minor pain, excepts for my left foot but it's tolerable. The biggie is today is day two with no med's at all, not even a Tylenol. If I start popping some "happy pills" I know the pain level would be zero. My personal choice is to avoid them if possible and I'm glad at this point I able to. Hopefully each day on the pain will keep abating. I'll post after week three.
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I had my nerve ablation done 2 months ago,lumbar spine. I still have pain in the back where they did the procedure, i cant sit for a movie at the cinema,let alone at work,and my sciatic pain in the leg is still there. The doctor never gave me any pain meds,just panadol?!?!?! I stopped taking lyrica a few days before the procedure,and im still not taking any pain meds. He was happy with my results, but, he told me after twelve days or so, u will be 100% pain free. I was dumb enough to believe. I know that these are nerves, but im sick and tired of having pain. Now,after one year of hell with my leg, now ,y back hurts from the procedure plus my usual leg pain! Im so tired of it all. Doc told me that if it doesnt work, then they will just give me an injection. I red up on that online, and the injection goes again to the nerves so, that means again weeks and weeks of dull aching in back and standard leg pain. What should i do?!
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My Dr. wants to do the RFA on my lower back. my concern is am I going to feel my legs if they get hit or cut??   I want this done cuz I've been in pain for 14  years now, and already had a fusion done.


                                                                               thank you
                                                                                        Lisa
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Just found this chat room about RFA.  Had right side of my neck done 12 days ago (RFA procedure).  Pain in right side of neck is diminishing, BUT now have burning sensation / intense soreness at mid to lower section of skull just above neck.  Dr. says this is "normal",  Has anyone else had their RFA on neck?  
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I had my RFA done a little over a week ago for my SI joint. Still in so much pain. Doc said it could take a minimum of 3 weeks for me to see any sort of results. Hoping it gets better. I've been miserable and can't sleep and I'm not one to take meds. Only taking anti inflammatory meds when I need them and really trying to hold off on the Vicodin fo my days off. Supposed to have a week of vacation in 2 weeks (day trips planned) and don't want to spend them on the couch.
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Hi everyone, I'm glad I found this forum with others experiencing what I've been experiencing for the last 5 years (though, not glad for the pain we're all sufferimg from).
I've had a couple of MRIs and the first showed that I have something called Degenerative Disc Disorder (DDD for short). Quite frankly, I've no idea how this came about. With the exception of landing on my tailbone when I took a tumble while on a  hiking some 13 years ago, I've not had any major accidents or events where my lumbar would've been comprised.
The pain has been constant and has affected my daily life. I'm not nearly as active as I use to be and my mood has gone from 'happy-go-lucky" kind of guy to Clint Eastwood in Grand Torino. I'm 44 and feel like crotchety old man.
I've had three sets of shots, with results that would be comparable to a single rain drop trying to raise the sea levels. In other words, zilch.
I had an  on May 2nd of this year and as of today, am still in allot of pain. I feel like I've not had a good restful sleep in YEARS. The location of the RFA does not hurt, that went away within a couple of hours, but the normal daily pain is still there. Gnawing at my life lol.
My apologies for the long post. I don't think I've expressed my amgoish to
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Well since my last post, the pain has subsided somewhat. I started PT last week and was given a Lidoderm patch to be used daily. From using my ice pack daily since my procedure, I've used it only here and there this past week. Hopefully this means I'm on the right track.
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This is an old forum and many who have posted here are long gone, however, it's still full of great information for new people in pain.

RFA treats the pain of spondylosis with neurolysis, which removes a portion of sensory nerve that innervates the spinal facet joints. This eliminates one source of severe pain.

However, back and neck pain of spondylosis also have other components. Over half of my back pain derives from the chronic strain and spasm of soft tissue -- muscles, tendons, and ligaments. RFA does not treat this pain.

After healing from the bruising and inflammation of an RFA procedure, physical therapy can help reduce the pain originating in stressed soft tissue structures. And to the frustration of many interventional pain doctors, medication is often still required after these procedures.

Still, I try to repeat RFA every 18 months (when my insurance company cooperates.) The reduction in daily pain, up to 50%, makes a big difference in my quality of life.
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I had RFA 2 weeks ago and I am still in pain anytime i try to do anything from sitting at my computer at work to just putting dishes away. My right leg is actually sore to the touch. and my lower back and legs just ache. Has anyone else experienced this. debating on going to emergency room as my Dr is closed for the day and really hard to get into see and already missed work to have it done
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Two weeks after normal RFA (I'm assuming this was lower lumbar, maybe L5-S1?), you should begin to feel better.

Often with spine disease, there are multiple factors that contribute to a pain syndrome. Pain can originate from multiple sources, depending on your diagnosis.

Were these symptoms present before RFA? Facet joint disease contributes only to one part of the overall  low back pain syndrome, and medial-branch RFA only treats facet-related pain.

What you're expressing feels like something other than recovery from RFA or facet pain, and if these are new pain symptoms, you should have a follow up.

What do your post procedural instructions say?

I'm afraid an ER doctor would not understand your clinical picture, and suggest that you first call your pain doctor as he/she is a better judge of your condition -- use the emergency contract means for days when the office is closed. Even if you go to the ER, your pain doc should be in touch with the ER doctor.

Good luck.
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