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What causes severe back pain after radiofrequency ablation?

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Posted on Wed, 25 Nov 2015
Question: I have severe degeneration disc in my lower back. I had a radiofrequency done about 3 weeks ago. About 3 days later I got severe muscle and back pain. I still have it and it's been 2 1/2 weeks. I have taken prescribed pain pills and muscle relaxers. Doesn't help. Could this be caused from radiofrequency or what. I have a very hard time getting up from sitting. etc. Please help. I am at my wits end
doctor
Answered by Dr. Muhammad Hanif (2 hours later)
Brief Answer:
Not due to radiofrequency.

Detailed Answer:
Thanks for the consultation at my virtual clinic HCM!
I have carefully worked through your case, and can well realize your health worries. Being your physician, I will take care all of your medical concerns today and will put my best efforts to get you out of this situation.


No-it is not due to radiofrequency. Most probably it seems to be due to degenerative disease of the spine in the lumbosacral region. May be added up by the intervertebral disc herniation/prolapse or bulge.

You need to consult an Orthopedist who needs to for an MRI to see for the cause of the disease. The treatment goes accordingly.


For pain you may take Fioricet with codeine.
Apply ThermaCare HeatWraps on the affected area.
Apply Voltaren Gel and massage gently.
Lumbosacral Corset will help you get better soon.
Avoid long time sitting, standing or running.
Avoid weight lifting/carrying.


Hope I answered all of your questions. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you with expert opinion. Please don't forget to give Five Star rating to help me assist my patients in a better way; and, please don't forget to 'Close This Discussion'.
For any disease you have, a timely follow-up is very necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in the start of your questions at HCM & I will be with you in no time).


Regards!
DR. XXXXXXX HANIF
USA

Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Muhammad Hanif (21 minutes later)
Thanks. The reason I thought it was from radiofrequency is because this muscle and back pain started about 4 days after I had it done. Isn't that a coincidence? so I thought that was the reason. Sometimes the pain is near SI joint and other times all across by lower back just below my waist. It changes places.
doctor
Answered by Dr. Muhammad Hanif (9 hours later)
Brief Answer:
Pain after Radiofrequency may be coincidence!

Detailed Answer:
Thanks for the consultation at my virtual clinic HCM!
I have carefully worked through your case, and can well realize your health worries. Being your physician, I will take care all of your medical concerns today and will put my best efforts to get you out of this situation.


It can be a coincidence that you got that pain right after the radiofrequency. Actually, if this was due to radiofrequency, it must have been OK up till now. It doesn't go so long with that.

Now I come to the changing or shifting pain. Such type of pain behavior is usually due to multiple origins and multiple causes of pain. e.g. Pain originating from muscles due to spasms, pain that comes from intestinal tract that may be due to constipation, pain that comes from degenerated spine area, pain from pinching of nerves that comes by intervertebral disc issues. When all of them combine, they cause it all.

You need to take the medications and do observe remedies as discussed above. If you have had constipation, avoid that through use of any OTC available laxative (Lactulose or any other medicine that suits you).


Hope I answered all of your questions. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you with expert opinion. Please don't forget to give Five Star rating to help me assist my patients in a better way; and, please don't forget to 'Close This Discussion'.
For any disease you have, a timely follow-up is very necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in the start of your questions at HCM & I will be with you in no time).


Regards!
DR. XXXXXXX HANIF
USA
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Muhammad Hanif (28 hours later)
hi. I had a MRI taken. I will attach part of it. of course, its hard for me to understand. can u give your take in it and what you think I can do to relieve pain? I am assuming that this pain may go away. but I will always have to be careful. I hope the attachment is clear. thanks
doctor
Answered by Dr. Muhammad Hanif (12 hours later)
Brief Answer:
You have degenerative changes in the Lumbosacral spine area!

Detailed Answer:
Welcome back and thanks for uploading the MRI report. It was really helpful in this case. I appreciate the assistance.


If we review the MRI report, it is clear that you have got very obvious degenerative changes in the lumbosacral spine (remember what I said in the very first answer. It is all confirmed by your MRI). It is totally obvious that you don't have the issue due to Radiofrequency therapy. It is the spine itself.


You have the nerve impingement at the level of sacroiliac areas that is causing this pain and discomfort. These nerves are actually exiting the spinal vertebrae and when there is narrowing of the foramina, or there is fusion of the adjacent vertebrae, patient feels pain in the area of supply of the nerve.

Kindly get back to your Orthopedist and start getting treatment after evaluation. Also start physical therapy but remember to ask them not to stretch too much and keep a balanced and healthy pace. To relieve the pain I have given the detailed medication guide in the answer above. That is the same until unless something is added by your Orthopedist.


Hope I answered all of your questions. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you with expert opinion. Please don't forget to give Five Star rating to help me assist my patients in a better way; and, please don't forget to 'Close This Discussion'.
For any disease you have, a timely follow-up is very necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in the start of your questions at this forum & I will be with you in no time).


Regards!
DR. XXXXXXX HANIF
USA

Above answer was peer-reviewed by : Dr. Sonia Raina
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Follow up: Dr. Muhammad Hanif (12 hours later)
thanks again! The pain I am having, is it the type that can go away and pop up again whenever or will I be stuck with this pain I am having now? thanks again
doctor
Answered by Dr. Muhammad Hanif (55 minutes later)
Brief Answer:
It has a variable pattern in different patients!!!

Detailed Answer:
Welcome back!

The pain of this type which has predominantly involved the nerves due to the compression between the articular structures (the spinal bones) is usually long standing and pretty much constant. May shift places and severity but it remains there as such until the root cause is resolved. Consider my suggestions aforementioned.

Hope I answered all of your questions. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you with expert opinion. Please don't forget to give Five Star rating to help me assist my patients in a better way; and, please don't forget to 'Close This Discussion'.
For any disease you have, a timely follow-up is very necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in the start of your questions at this forum & I will be with you in no time).


Regards!
DR. XXXXXXX HANIF
USA

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Muhammad Hanif (1 hour later)
Thanks. of course, I don't want surgery and will avoid it if all possible. so you are saying that physical therapy may take pain away? and meds will help, but I will always have this problem
doctor
Answered by Dr. Muhammad Hanif (9 minutes later)
Brief Answer:
Yes physical therapy will help to some extent!!!

Detailed Answer:
Welcome back with a follow up!

Yes physical therapy helps but to some extent. It relieves the strain on the soft tissues due to the Guarding effect of the muscles and tendons as in a response to the pain.

But the origin of the pain, the nerve compression and the degenerative processes of the spine are still there and they are continuously pinching on the nerves producing pains. As you don't want to opt for surgery, We can get help by supportive medical treatment as aforementioned to take the pain to a bearable level. Also Cognitive Behaviour Therapy may be helpful.

Hope I answered all of your questions. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you with expert opinion. Please don't forget to give Five Star rating to help me assist my patients in a better way; and, please don't forget to 'Close This Discussion'.
For any disease you have, a timely follow-up is very necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in the start of your questions at this forum & I will be with you in no time).


Regards!
DR. XXXXXXX HANIF
USA

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Muhammad Hanif (33 minutes later)
hi again. Wouldn't the radiofrequency have helped with the nerve? thanks
doctor
Answered by Dr. Muhammad Hanif (2 hours later)
Brief Answer:
Yes it helps for many patients but not for all!!!

Detailed Answer:
Welcome back with a follow up. I am happy to assist you.

Yes--Radiofrequency ablation (RFA) or Radiofrequency Neurotomy, is helpful for many patients but not for all. It helps many through its beneficial effects. But if the nerve causing the pain is not exactly focused in the treatment procedure then obviously there will be least benefits. In such a case repeat procedure is good for better results.


Also we should keep in mind that RFA works good only for 6-11 months and we need to repeat the procedure afterwards. So it is not a permanent cure, but only a temporary relief from pain. Also its efficacy depends on the severity of degeneration of the bones and extent of compression of the nerves involved.


Hope I answered all of your questions. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you with expert opinion. Please don't forget to give Five Star rating to help me assist my patients in a better way; and, please don't forget to 'Close This Discussion'.
For any disease you have, a timely follow-up is very necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in the start of your questions at this forum & I will be with you in no time).


Regards!
DR. XXXXXXX HANIF
USA
Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. Muhammad Hanif

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Practicing since :2009

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What causes severe back pain after radiofrequency ablation?

Brief Answer: Not due to radiofrequency. Detailed Answer: Thanks for the consultation at my virtual clinic HCM! I have carefully worked through your case, and can well realize your health worries. Being your physician, I will take care all of your medical concerns today and will put my best efforts to get you out of this situation. No-it is not due to radiofrequency. Most probably it seems to be due to degenerative disease of the spine in the lumbosacral region. May be added up by the intervertebral disc herniation/prolapse or bulge. You need to consult an Orthopedist who needs to for an MRI to see for the cause of the disease. The treatment goes accordingly. For pain you may take Fioricet with codeine. Apply ThermaCare HeatWraps on the affected area. Apply Voltaren Gel and massage gently. Lumbosacral Corset will help you get better soon. Avoid long time sitting, standing or running. Avoid weight lifting/carrying. Hope I answered all of your questions. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you with expert opinion. Please don't forget to give Five Star rating to help me assist my patients in a better way; and, please don't forget to 'Close This Discussion'. For any disease you have, a timely follow-up is very necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in the start of your questions at HCM & I will be with you in no time). Regards! DR. XXXXXXX HANIF USA