Lumbar Nerve Ablation – Treatment Review
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Given the severity of symptoms coming from my lower back, and finding degenerative changes including facet arthropathy, the pain clinic offered nerve ablation to address my pain.
Before you can have the actual nerve ablation, which uses radio frequency to burn the nerve, there are two rounds of a diagnostic test in which they apply lidocaine to the same nerves. In horses, this procedure uses both lidocaine and cortisone, but because I am a Zebra (having a connective tissue disorder) they cannot use cortisone for me.
We skipped forward to the ablation option, because epidural cortisone injections are also not an option due to the hypermobility.
In my procedure we targeted the L3, L4, and L5 nerves that run through the facet joints.
You’re probably in a cult.
Round One
To begin, they administer conscious sedation through an IV. This is supposed to make you sleepy, and inhibit memory of the procedure.
Lucky for you, that part didn’t work so I remember every single detail. Not so lucky for me.
They bring you into the procedure room and have you lie face down on a table.
Without much warning for the first round of diagnostic, they applied a very cold liquid to my back which made me tense up, and the first needle was applied almost immediately afterward.
As the needle hit the nerve it cause a wildly electrical burning/stinging sensation at the site of the injection. It was absolutely horrifying.
When that electrical sensation hit, my body responded reflexively, and several of my muscles involuntarily clenched. The Dr. warned me that if I kept it up, I would break one of the needles going into my spine.
This came across very much as a threat.
They have to leave the needles in for a little bit, which is a pain that is possible to breath through. The sensation continued to feel electrically “lit up,” but not as intense as when the needles first hit the nerve.
Then they remove the needles, which sting, and let you get up and back to the chair you were in for the IV.
They give you a little space to recover from the procedure, and give you instructions for filling out your pain log for the rest of the day.
They offer snacks (I believe due to the sedation) and none of the snacks are low carb.
Then after a few minutes they walk you out and send you on your way.
For the next 8 hours, they have you log your pain number from 1-10, and describe how your pain felt and what activities you were doing. They instruct you to have a “normal day” and participate in activities that would likely aggravate the pain. They also advise you not to push it.
This provides a picture of how much relief might be afforded from the actual ablation.
The best my pain got was a 6. When I walked in that morning it was a 7.
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Round Two
The second round of injections took place three weeks later. Given my insensitivity to the conscious sedation, we did the second procedure fully awake.
It was really just as bad, if not actually worse than the first round.
I prepared myself for the pain. I was breathing, calming, meditating, going to my pain place in my head… I used every single tool within myself.
When the first needle hit the nerve, my left leg jumped involuntarily off of the table.
One of the worst feelings of my entire life occurred as I tried to lift my leg back onto the table with the needle in my nerve.
They offered a lidocaine spray on the surface and said it might help. The liquid sensation made it hurt so much more. Trying to speak to communicate that was incredibly difficult.
There were no snacks or relief following the second procedure. I spent the rest of the day with my back lit up, and the electrical sensation stayed with me long after the needles were removed.
My diagnostic tests failed and I was not able to get the nerve ablation.
The nerve ablation would have been very similar to the lidocaine shots, but the needles would have stayed in my back while a radio frequency is applied to ablate the nerve.
I received both diagnostic rounds in January. It’s now March and I still feel the lit up feeling in my back as a result of the diagnostic rounds. It’s not nearly as bad as it was during the injections, but it also hasn’t gone away.
Despite my hopes that this might have actually given me long lasting pain relief (approximately 6 months), this process made my pain worse, and the experience was hellish.
Since then, it has been more difficult for me to be openminded about pain relief tactics, because the consequences of trying can be catastrophic.
Next Steps
So, moving forward, my next option is a spinal cord stimulator, which uses TENS-like impulses to confuse the pain signals to the brain. This is an implant that goes under the skin with leads to the spinal cord.
In addition to being terrified that this will somehow go terribly wrong the way the ablation diagnostics did, there are reports that the implant itself (about a 2″ square, flat device) can be uncomfortable and painful to the touch when you lay on it or sit on it.
I want to have a good attitude moving forward, but it’s difficult to feel like a guinea pig, while my pain is made worse.
Stay Tuned
If you have any questions or feedback, please reach out to me at ProtyusAGendher@gmail.com.
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