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nerve block question.

Not being a hard ass, but all the above have been applied for years now. Surgery is off my book till I die. I still appreciate your input.
Is your nerve pain coming from the discs or facet joints? If it’s coming from the facet joints, I’d recommend “radio frequency ablation” to kill the nerve. Gives good pain relief for about 6 months for many.
 
can someone correct me if I'm wrong but isn't rfa (Radio Frequency Ablation aka Radio Frequency Nerve Ablation) the most common type of Rhizotomy performed by Pain Mgmt specialists?
Don’t know. My doctor used the word ‘burn’. I never asked any more questions. He offered it up as of it was no big deal.
 
And notorious.

Tried rhizotomy? Heat.

My doctor mentioned it to me. I have disc degeneration and arthritis is my low back. Inherited. Good and bad days but always tolerable for now.

He did caution me about lifting as the loss of sensation could be problematic and could cause damage that would, may have been, otherwise avoided.

I’m not there yet.
Yes i have degeneration and arthritis too according to mri not only by my pain Dr but also at the hospital when they did a recent mri
 
Again, I think you are mistaking a "nerve block" for a "steroid injection". Ask you doctor what he is injection when he gives you what you refer to as a "nerve block"?. I bet it has steroid in it. To block a nerve you need a drug to block the signal to the brain and anesthetic agents last hours and not months. Its typical to inject a steroid to decrease inflammation and potentially give long term relief like months in your case.

They do "nerve block" injections for facet pain as well, diagnostically, prior to considering "burning" the nerve and that is aimed at the medial branch of the the nerve exiting the spine and called a medial branch block. Again, that is following typically be another procedure if the person does in fact have relief from the " nerve block." In rare cases medial branch blocks create lasting relief more than hours.
According to him his injecting me and also actually burning the end of the nerve I have one coming up next month I'm ask him before the procedure
 
Don’t know. My doctor used the word ‘burn’. I never asked any more questions. He offered it up as of it was no big deal.
Yea my Dr uses the word burn but also radio frequency abliation i beleive.I'll ask next month
 
Subbed. This is very interesting to me especially as I have chronic back issues and extreme pain flare up seemingly every 6 months or so out of nowhere.

Im am very cautious about procedures on my back though before I try all other possible routes.

IMO these types of things become necessary only when your QOL has greatly degenerated.
 
can someone correct me if I'm wrong but isn't rfa (Radio Frequency Ablation aka Radio Frequency Nerve Ablation) the most common type of Rhizotomy performed by Pain Mgmt specialists?
There are several differences between DVR ( Rhizotomy) and RFA ( radio frequency nerve ablation). The biggest difference is the permanence of the pain reduction they provide. With RFA, the nerve fibers are burned to reduce pain, but they will heal over time and the pain returns. Still much safer than permanently killing a nerve. Cortisone injected into the Discs is the most common procedures performed by pain specialists. RFA would be next in line. Rhizotomy is rarely performed, if at all, nowadays from my understanding.
 
There are several differences between DVR ( Rhizotomy) and RFA ( radio frequency nerve ablation). The biggest difference is the permanence of the pain reduction they provide. With RFA, the nerve fibers are burned to reduce pain, but they will heal over time and the pain returns. Still much safer than permanently killing a nerve. Cortisone injected into the Discs is the most common procedures performed by pain specialists. RFA would be next in line. Rhizotomy is rarely performed, if at all, nowadays from my understanding.

Rhizotomy, 'burning the nerves', like you said, they do recover over time (6mo to 2 yr?)
is very common according my doc. No big deal if the attending knows what they are doing
but that is true for all medical procedures . . . you just hope that he / she is not having
a bad day :)
 
There are several differences between DVR ( Rhizotomy) and RFA ( radio frequency nerve ablation). The biggest difference is the permanence of the pain reduction they provide. With RFA, the nerve fibers are burned to reduce pain, but they will heal over time and the pain returns. Still much safer than permanently killing a nerve. Cortisone injected into the Discs is the most common procedures performed by pain specialists. RFA would be next in line. Rhizotomy is rarely performed, if at all, nowadays from my understanding.
Not trying to start and semantic argument but I'm reading something different from you or I've misunderstood.

 

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Nevermind
 
According to him his injecting me and also actually burning the end of the nerve I have one coming up next month I'm ask him before the procedure
I have a feeling you had a medial branch block and are going for a radiofrequency ablation/rhizotomy for local back pain.
 
This is the denial from insurance I'm fi s the bill ti see exactly what Dr does to my back
 

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So I believe the paper you showed accurately describes the injections and why you do them. To me, I bet the "office note" or notes prior to your injection described you as having leg pain or back and leg pain/did not highlight your back pain was above whatever criteria the insurance requires and this could be just verbiage under the subjective or objective part of the note. Being the injection was already done I think the doctor would need to write a letter of medical nessecity or change his/her past note and then resubmit or do a review with the insurance. If not you probably have to pay cash in which larger hospitals sometime reduce prices.
 
Not trying to start and semantic argument but I'm reading something different from you or I've misunderstood.

Apparently an RFA is just another form of rhizotomy. I thought cutting was Rhizotomy and burning the nerve was ablation. Having stem cells injected into the facet joints to grow additional cartilage might help some in the future. But once the facet joints get advanced arthritis there’s bone compressing on the facet joint nerves. The muscle spasms from such can be breathe taking and disabling. The acute pain from a small facet joint nerve being compressed can be as bad, if not worse, than a large nerve being compressed by a herniated disc. Back pain is no joke!
 
Apparently an RFA is just another form of rhizotomy. I thought cutting was Rhizotomy and burning the nerve was ablation. Having stem cells injected into the facet joints to grow additional cartilage might help some in the future. But once the facet joints get advanced arthritis there’s bone compressing on the facet joint nerves. The muscle spasms from such can be breathe taking and disabling. The acute pain from a small facet joint nerve being compressed can be as bad, if not worse, than a large nerve being compressed by a herniated disc. Back pain is no joke!
I was always under the impression that Rhizotomy, Radiofrequency Nerve Ablation, and Nerve Burn all meant the same thing and depending on your doctor, were used interchangeably. I've heard very mixed things about stem cell treatment for spinal injuries. In fact, one of the leader/pioneers of that industry, Dr. Neil Riordan, has stated publicly that "we weren't there yet" in terms of how to use stem cells for lower back injuries. Hopefully, that will change. RNA helped me a lot w/my facet joint issues. Currently, I'm recovering from a microdiscectomy and my back hasn't felt this good in fifteen years. The true test however will be when I get back in the gym.
 
For the fourth time I am advised by a pain management specialist to consider a nerve block for my back pain. Anyone has done it and what were the overall pros and cons of it based on your own experience? Thank you.
When I had my knee surgery the ortho MD used a nerve block to deaden the pain for post surgery. It definitely took care of my pain but unfortunately its only short term. Once it wears your gonna have the same issue/

Bottom line.....nerve blocks work 100% but its only a temporary solution.
 
So I believe the paper you showed accurately describes the injections and why you do them. To me, I bet the "office note" or notes prior to your injection described you as having leg pain or back and leg pain/did not highlight your back pain was above whatever criteria the insurance requires and this could be just verbiage under the subjective or objective part of the note. Being the injection was already done I think the doctor would need to write a letter of medical nessecity or change his/her past note and then resubmit or do a review with the insurance. If not you probably have to pay cash in which larger hospitals sometime reduce prices.
I asked Dr he said they do RFA
 
I've heard very mixed things about stem cell treatment for spinal injuries. In fact, one of the leader/pioneers of that industry, Dr. Neil Riordan, has stated publicly that "we weren't there yet" in terms of how to use stem cells for lower back injuries.
Interesting... my "stem cell" doc who has won multiple awards has great success with back/spine injuries... but that back/spine/ribs* is one region he almost always does with Prolo of all things. *Ribs are a HUGE part of a back/spine treatment.

Needless to say, as someone who typically opts for stem cell, the first time I got my back/spine treated and my doc mentioned Prolo, I was thinking WTF (since stem cell is generally considered the gold standard, then PRP, and Prolo is usually considered the lowest "tier"). My doc mentioned that in his experience, results with Prolo were equal to or better than with stem cell (meaning, NO justification to drill in to one's bone to do a BMAC!). That said, there are ALWAYS exceptions; each patient is different and the spine can be more complex.

For me, the spine was generally pretty darn good and I've never had back pain or injured my back/spine per say; thus, I'm not going to be the best judge of this; but given how my doc's treatments have FIXED, in full, other areas of my body that I had done a number on, I don't doubt his treatments can work miracles for someone with more severe back/spine too.

Bottom Line: I cannot recommend stem cell (non-spine) / prolo (spine) enough! ...and from both my prior and recent experiences: with some HGH thrown in for faster healing!!!

But DO YOUR HOMEWORK: There are other docs in my area who do stem cell/PRP/Prolo (as one of a whole gamut of treatments) and the results are NOT what they are with my doc (not that I can say from personal experience, thank gosh, that those other docs are inferior!); but rather, I've known people who have gone to other docs for mere sprains / stuff that should have been FULLY HEALED (and HEALED BETTER) with my doc... only to continue to have problems / get less than ideal recovery.

If you can find a doc who focuses his/her entire practice around stem cell/prp/prolo (i.e. regenerative injections) that is typically going to be a good sign / much more ideal than a doc that offers stem cell/prp/prolo as ONE of a whole gamut of other treatments. (think specialist VS generalist!!!)
 
I had prolotherapy done a couple of times on my lumbar spine as well as my thumbs. I would say it worked pretty well. Its just sugar too which is tons easier compared to PRP and stem cells.
 

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