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  • narcoleptic
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    Post count: 2

    I HAVE HAD BOTH RIGHT AND LEFT LUMBAR NERVE ABLATION FOR SACROILLIAC PAIN. ITS BEEN 5 WEEKS ON THE RIGHT ,3, ON THE LEFT. THE PAIN JUST STARTED ON THE 4TH WEEK TO GET BETTER ON THE RIGHT,AND 2 DAYS AGO WE HAD THE HEAVY RAIN, AND SUDDENLY THE SPASMS I GOT WERE DREADFUL. I STILL FEEL BURNING ON EACH SIDE, IS THIS BECAUSE THE NERVE IS STILL BEING BURNED OFF. HOW LONG BEFORE THE PROCEDURE REALLY IS HEALED. LITERATURE SAYS 3 WEEKS ,BUT IT MUST TAKE LONGER BECAUSE BEFORE I FOUND THIS NEW DOCTOR I HAD GOTTEN 3 INTRALAMINAR EPIDURALS FOR HERNIATED DISC, SCIATICA WHICH DID NOTHING . THE I DID THE NERVE BLOCK FOR THE TEST TO SEE IF I AM A CANDIDATE FOR ABLATION WHICH SHOWED THAT THE PAIN LEVEL WENT DOWN FROM A 10-TO A 2. NOW WE DO THE ABLATION AND ALTHOUGHT ITS EARLY THE PAIN HAS GONE NO LOWER THAN FROM A 10 TO AN 8. WILL THE PAIN LEVEL LESSON DOWN TO THE NUMBER 2 AS IT DID WHEN THEY DID THE NERVE BLOCK. THANKS.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8468

    Sacroiliac pain is a difficult disorder to treat. The nerve ablation technique is a treatment I am a fan of but there are some anatomical roadblocks to this technique. The sacroiliac joint is innervated by nerve branches from both the front and the back of the joint. The ablation can only destroy the nerve branches in the back of the joint. This, of course leaves the anterior branches intact and chance for failure is not small. After six weeks, if there is not significant improvement, this technique is unlikely to work.

    There is another technique called prolotherapy. This involves injection of a toxic substance (phenol, concentrated sugar or salt water) into the joint to cause fibrosis (adhesions) which in turn stabilizes the joint and reduces the pain. One of the contraindications is a tear in the anterior capsule of the joint. The sciatic nerve sits on the front of the sacroiliac joint. Any leak of this toxic substance onto the nerve can have significant consequences.

    The original sacroiliac injection should have had a small amount of dye injected before the numbing medication and steroid is injected. If this dye leaked out the front of the joint, the prolotherapy technique is contraindicated.

    If the joint is truly the source of your pain, you have disabling pain and you fail all other treatments, you could be a candidate for a sacroiliac fusion.

    Dr. Corenman

    Dr. Corenman

    narcoleptic
    Member
    Post count: 2

    This is going on week 6 for the right side. I did have a remarkable reduction in pain for it went from a pain threshold from 10 down to a 2. But now it seems to have come back after 2 days . There is burning pain in the buttocks. Ice is the only relief I get. I also suffer from cataplexy which attacks of muscle tone is triggered by pain. Since I am a slow healer for anything all my life. Is 6 weeks regardless the cut off date . My back is so sore . Before the ablations I had 3 epidurals, the test to see if the ablation would work, that I was wondering that the hot burning pain I have on the right side, is that meaning that the nerve is still burning.thanks

    Donald Corenman, MD, DC
    Moderator
    Post count: 8468

    I assume you mean that you had three sacroiliac blocks and not epidurals prior to the ablation. If you had epidurals (the dura is the membrane in the spinal canal and does not exist in the sacroiliac joint), these injections would not diagnose sacroiliac syndrome.

    If the “hot burning pain on the right side” originates from the sacroiliac joint (the injections into the joint gave great temporary relief-see pain diary) and the ablation allowed pain to return after six weeks, the ablation was not effective.

    Dr. Corenman

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