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  • exercise453
    Member
    Post count: 53

    Hi Doc,

    I have a left side symptomatic c2-c3 facet. I had a block which seemed to work and then a radiofrequency procedure (4 months ago). The procedure did not work very well and the symptoms returned quickly. It may not have worked at all. The one sided symptoms are pain at and just below the hairline level. Sometimes back, or side or around the front. From trauma (whiplash) it is a badly symptomatic joint, radiating down the neck as well as side of face, around the ear and same side back of head. It is very tender. A chiropractor who was feeling around generally said he felt swelling and without knowing asked me if it hurt there. No headaches. It hurts to turn in that direction. The competent, experienced, interventional pain management doctor is going to repeat the procedure.

    Is it uncommon for a radiofrequency to not “take” and why?

    If a unilateral c2-c3 facet is damaged how far can pain refer down the neck? It hurts a few levels down but when I search I wind up back at that same spot.

    Can a facet cause tenderness and swelling?

    Does a redo stand a chance of working?

    Your site and generosity are extraordinary
    thanks

    exercise453
    Member
    Post count: 53

    Also if bad enough can this upper facet radiate into the trap or a bad shoulder or make it feel like it does?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    Typically, the upper facets (C2-3 and C3-4) cause pain at the base of the skull and headaches (greater and lesser occipital nerves). They will not radiate pain into the shoulder in my experience.

    Radiofrequency ablation works about 70% of the time. I think the reason for lack of success is the variable anatomic distribution of these nerves. Not all nerves have read the textbook as to where they are suppose to be. A burn of the area may not destroy the nerve if it is “out of position”.

    If the procedure is successful, the nerve can attempt to grow back. After all, peripheral nerves do try to regenerate. It takes about 7 months to 1 1/2 years to grow back.

    Inflamed facets do cause tenderness and swelling. This is how I can tell through palpation if the facet is a pain generator (remember that I am a chiropractor too).

    Redo ablations can be successful if the first one was successful.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    exercise453
    Member
    Post count: 53

    Hi again doc,

    In a cervical radiculopathy where there is more neck than arm pain (75-25), no loss of muscle strength but definitely strong multilevel sensory symptoms, will periodic epidurals, while easing symptoms, also prevent or slow down further deterioration of nerves, nerve roots etc?

    If there is pressure on exiting nerve roots, enough to create sensory discomfort but muscles are full strength, does it have to eventually affect motor function or can it remain as it is?

    Thanks again

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    Periodic epidurals will not prevent deterioration of the spine or the nerve roots. The epidural reduces inflammation and inflammation causes dysfunction of the nerves.

    Many people have a sensory radiculopathy without motor impairment and live their whole lives with it.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    exercise453
    Member
    Post count: 53

    Sorry to ask again but I don’t understand your answer. If periodic epidurals reduce inflammation, and inflammation causes dysfunction then wouldn’t the epidurals slow down deterioration, at least while the steroid in effect?

    And if a nerve is temporarily uninflamed and thus smaller, cannot healing be promoted while it is under less pressure? (wishful thinking)?

    Thanks so much Doc…the website and forum, including other peoples posts have answered many questions that have plagued me for a long time and clarified what to do and not do.

Viewing 6 posts - 1 through 6 (of 30 total)
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