I’ve been having back issues since a discectomy in 2004. Now at approaching 60, I’ve had three rounds of epidural steroid injections since 2019 and I’m scheduled for my second nerve block on Tuesday. The doctor spoke of me getting an ablasion and I wasn’t really excited about it. The last steroid injection didn’t really help, and I was told the ablasion wouldn’t last but about a year. I don’t really want surgery, but would I be better in the long run to just get it done instead of going back year after year? It’s the usual; L4 L5 S1 with stenosis.
I also have degenerative disc disease. It’s altered my walk and given me bursitis in my right hip as well
Radio-frequency Ablation (RFA) is designed to diagnose and treat a different problem that epidural steroid injections (ESI). The facets are a smaller paired set of joints in the lower back. They can be “blocked” with a numbing agent either by numbing the nerve that sends signals to the brain (Medial Branch Block or MBB) or by injection directly into the joint (capsular blocks or intraarticular blocks). If the facet is the major pain generator, there will be 2-3 hours of at least 60% relief.
The RFA then is employed which ablates (burns) the medial branch, thereby disconnecting the facet from the brain so pain signals do not continue to be transmitted. Unfortunately, these peripheral nerves attempt to regenerate within a year reintroducing pain to the brain. A repeat RFA can be considered if pain recurs.
If the problem is disc pain generation, the RFA will be unsuccessful. The same could be said if the pain is generated by the nerve (nerve pain). If nerve pain is the cause, a decompression or a fusion could be needed. If purely disc pain, fusion is considered.