Why You Should Never Get A Radiofrequency Ablation For Chronic Back Pain

Radiofrequency Ablations procedures are often done to treat chronic lower back pain. Doctors tend to downplay this procedure by saying it is not invasive or “minimally invasive” and that it is a day procedure that can be done in their office instead of the hospital.
Yet they don’t always let their patients know how permanent and possibly damaging an RFA can be for chronic back pain.
Patients usually end up getting offered a radiofrequency ablation when they have not had back pain relief using medications or injections. This is a procedure that is offered before getting spine surgery.
If physical therapy did not work out in helping your back pain, don’t give up on it yet! There are all different types of physical therapy and doctors don’t realize this! You may have gone to a physical therapist that did not fully understand your back problem.
We offer an online comprehensive exercise program for back problems right here!
It’s called the 28 Day Back Health & Wellness Boost Program.
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00:00 Why You Should Never Get A Radiofrequency Ablation For Chronic Back Pain
00:52 When would a doctor offer you a RFA?
02:18 Which Nerve Is Burned?
03:10 What Is The Downside Of RFA?
05:38 What to do instead?
08:28 When is an RFA a good idea?
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DISCLAIMER:
Any information available at this channel is intended for general guidance only and must never be considered a substitute for advice provided by a physician, medical provider or physical therapist. El Paso Manual Physical Therapy will not be liable for any injuries that happened due to performing any exercises or advice on this channel.
Always seek the advice of your physician or other qualified health care professional with questions about your medical condition or to diagnose any conditions.

[@brandonwoldridge1417]

I've had three RFAs on my lumbar spine in three years, and am about to get my 4th. Just to give my two cents, it has worked extremely well for me and lasts about a year before the nerves grow back. With RFA, I resume going to the gym and lifting weights, riding bmx, all of the things I love to do. Without RFA, all of that is impossible. I have not experienced any adverse side effects. The procedure is painful (the initial numbing shots), but absolutely worth it to be able to be completely active and do the things I love. I'm a 52-year old male.

[@epmanualphysicaltherapy]

Hey Brandon, thank you for sharing your experience! This procedure can definitely have its benefits when performed properly. Unfortunately, we have also heard many stories that are not as successful as yours. We are glad that you have been able to get back to doing all of the things you love and encourage you to check out our content on how to heal your lower back. The exercises and stretches we support can help to eliminate the need for these RFA procedures in the future. In case you are interested, here is a link to a playlist that contains a lot of information on healing the lower back: Back Pain Exercises & Stretches kzbin.info/aero/PLJVIPiFvv1mYkrbLk-F5KsUcHPEkdDF-u

[@123Goldhunter11]

Physical therapists seem to live in woo woo land.

[@gustavocardenas4883]

Hey man, I’ve been having back pain in my lower back due to L5-s1 spondylosis. I saw an orthopedic and pain management doc he suggested I get the procedure done. I am a 33 year old male that has worked construction for the passed 10 years I have had an active lifestyle in the passed. Any insight to calm my nerves?

[@jamesmtnbkr]

My same experience as yours its helped so much . Without this procedure i would be toast

[@narmypara100]

I'm about to have this done on this Monday as big as I am I'm terrified ..I'm 52 long term bodybuilder mine was damaged over time with heavy weight lifting ..I'm like a zombie everyday with a cocktail of codeine pregablin and dulotetine and valium ..the quality of life is 💩I've went from a 18 stone bodybuilder to an old man over the last 6 months ..but everyone of my friends are drilling it into my head to not have it done as the nerves grow back bigger and worse . Also the procedure is so painfull ..my head's battered and I'm ready to cancel it ..but if I do I'm stuck in this horrible circle of daily pill popping and codeine addiction ..getting out of bed and off a chair I'm like someone who's 90 .what's your thoughts on this people I appreciate any feedback ..I feel like death and my life ATM isn't worth living thanks 💙

[@drandadeleon9327]

I had this done yesterday. I'm walking better and have reduced pain. I was told I'll see more results in two weeks. Dealt with lower back pain for 6 years

[@thomasbaker8174]

This is "sensationalism"... The title states "never get RFA" but then he states in these circumstances you should consider it. I am a pain specialist and there are 1000s of reasearch articles with excellent saftey outcomes for more than 20 years! If you are seeing a board certified pain specialist, and they are using flurorscopic (x-ray) guidance then this procedure can be performed with very low risk of permanent injury and any long term side effects are exceedingly low. I agree that this is not the first step in treatment for back pain... patients should have tried basic treatments like over-the-counter medications (acetaminophen and ibuprophen or naproxen), should have a seen a physician and had additional treatment like prescriptions NSAIDs or muscle relaxer, physical therapy or chiropractic treatment, and if pain persists they should have had x-rays and advanced imaging MRI or CT of spine. Additional more conservative treatment might include antidepressant and seizure medications used for pain. If these more conservitive options fail then and only then would one consider lumbar medial branch block and possible radiofrequency ablation. (Most insurance companies require this step wise approach). It is incorrrect to state this is one step away from surgery as the indications (symptoms and findings) for spine surgery are signifcantly different than the indications for MBB/MB RFA. One of the first studies was 22 years ago: Dreyfuss, Paul et al. “Efficacy and Validity of Radiofrequency Neurotomy for Chronic Lumbar Zygapophysial Joint Pain.” Spine 25.10 (2000): 1270-1277, which is available for free on the internet.

[@Hash4ever]

I have had chronic pain for some 27 years after workplace accident that was called a 'crush' injury to my neck and left shoulder. The year it happened; I had a 2 level fusion at C5-6-7. The fusion then failed as the cadaver bone disintegrated and I was left with one of the 5 screws just loose in my neck at C-6-7 with the remaining 4 screws still attached to the titanium plate. I have been in constant pain increasing each year as spurring has occurred and osteoarthritis, especially in the joints above and below the fusion. Back in 2009, I had the RFA done in the area of C-5-6-7 and had some relief. Now, some 27 years since my accident and 13 years since the RFA, I am seeing a new pain specialist that recommended it be done around C-2-3-4 areas. The Medial Branch Block testing was started 4 weeks ago and went smoothly. Yesterday, the second test was done. It did not go well as I began to experience symptoms of severe hot flash, dizziness, and nausea. It was scary and lasted about an hour or so. After researching the symptoms and hearing the doctor mention what might have gone wrong, this is what might have happened: accidental injection of the medication into a blood vessel and not the targeted nerve. Have you heard of this happening and could it have been avoided?

[@lane2063]

Outstanding reply. You basically took the words right out of my mouth. There are established protocols, not to mention insurance rules and policies, that are followed before RFA is considered. No competent provider will claim complete and permanent pain relief from RFA. For most of us RFA follows PT and other conservative modalities. In my case it was used in an attempt to postpone a more invasive procedure. PT won’t address arthritic facet joints. To suggest some causal relationship between RFA and stenosis, annular tear or rupture is without merit and makes me question his motives.

[@Lovepeacejoy..]

Thank you so much for this information.

[@jai11301966]

Thank you for your input doc. I was very skeptical of having a sacral iliac rfa after watching this video. My pain specialist mentioned not to pay attention to this particular video

[@brianhicks8980]

100% agree, I’ve had great experiences with RFA’s in cervical and lumbar spine.

[@sunbeamfactory5171]

I have severe osteoarthritis in my cervical and thoracic spine, and RFA is the only thing that offers me lasting relief. If I have the procedure once every 6-12 months, I can move like a normal person. If I don't, I'm in so much pain it interferes with my quality of life. RFA forever, as far as I'm concerned.

[@crispycruiser4654]

It’s extremely risky though. For those whom it doesn’t work, they get MUCH worse and many complain of round the clock 9 or 10 pain. It totally ends them. Again, BURNING YOUR NERVES is very risky and there’s no way of knowing if the nerve will grow back angry or a nearby nerve will overreact. And then there’s no treatment once you’re damaged.

[@sunbeamfactory5171]

@@crispycruiser4654 I just had my cervical spine done again the other day, and am having my thoracic done soon. I don't want anybody to be reticent about having this procedure when it can make such a difference in quality of life.

[@nesschap]

Thank you. I just had it done yesterday. Really hoping this works.

[@072010SIGHT]

@@nesschap did the RFA work for you?

[@nesschap]

@@072010SIGHT yes, it absolutely did. I am still on some pain med but minimal...I would definitely do it again.

[@piratesplay940]

I had this procedure done and had 100% success! The pain in My lower back, buttocks, and sciatica in my lower legs has all stopped. No issues at all. The doctor first has you receive numbing at the oblation spots to see if the oblation procedure will work for you. The numbing procedure usually provides pain relief for 1 day. If it works, they’ll schedule you for the oblation.

[@leemassey9065]

I'm thinking about getting the procedure. They are talking about starting with nerve blockers to pinpoint where the bad nerve is at. And then burning the nerve

[@phoebeanthony8094]

MINE DID NOT AND IM PISSED

[@Chong888]

请问做完这个手术,你多久才感觉没腰酸了。

[@dirtydingus5465]

Me too. I’m on my 3rd ablation. I get just about a year totally pain free. It’s a life saver!

[@dirtydingus5465]

@@phoebeanthony8094 Sorry to hear this! Maybe try a different doc? Mine has worked 3 times now. I get a full year+ out of the procedure!

[@albagarcia3172]

Just had this done 2 days ago . I’m amazed. Don’t listen to this guy. My neurologist did a great job. I was miserable before this.

[@thestork2210]

how is it now?

[@rosemaryyoung4152]

I wish mine had worked better. I'm still doing physical therapy as well so I don't know what I'm doing wrong

[@braydenspringate7485]

Had this done yesterday and I’ve had them before they hurt like hell don’t work, I have herniated disc,spinal stenosis,and had a pain pump all failed 😞 also did 6 months of therapy.

[@narmypara100]

Same ..amazing results I can stand tall again and weight train and climb ..walks the whole works I feel great

[@dcsj6837]

@@rosemaryyoung4152 Didn't do anything for me. The pain killing meds they injected worked better for a couple of days but the actual RFA did nothing. Tried it a couple of times and won't do it again.

[@matthewlivermore5453]

I can tell you that as someone with at least 3 herniated disc’s in my neck, PT and medication didn’t work. I am in so much pain all the time, that in the last year I’ve averaged about two to four hours of sleep every night. Yes RFA is temporary. But, since having it done on the right side of my neck I have been able to add an additional 1 to 2 hours of sleep each night. And, we are currently in the process of doing the left side. And, I am fully aware of the fact that I will most likely be needing neck surgery at some point in the future. But, at least for the next few months to a year…I will have little to no pain in my neck. I can live with this trade off. What I can’t live with is my constant pain. I will take this information under consideration and advisement. Because, once my neck is done…we will begin working on my lumbar spine, where I have two more herniated disc’s. And, since I know that PT doesn’t work for me…I may seek out a chiropractor this time.

[@epmanualphysicaltherapy]

Hey Matthew, it sounds like you've carefully weighed out all the aspects of getting an RFA. That's the most important thing for you to do! It's great that you have this info and can apply it moving forward into the best decision for you. We sincerely hope you find relief and get consistent, restful sleep.

[@morganschiller2288]

Or you can find a surgeon you trust and get it fixed. No amount of PT is going to raise the disc height you’ve lost. That’s what bothers me the most about chiropractics and PT. Most don’t know when to stop and they din’t understand how disabling the pain is.

[@Midnitescarlett]

Be careful with herniation and chiropractic. It actually made my lower back worse, BUT it helped everywhere else.

[@jlutie2943]

I had the same neck problems more or less but 4 disk completely gone there are no meds or pt that will help I had to get ACDF surgery I waited to long c-3 c-7 4 level I'm still recovering 18 months later but that was me

[@yahya4370]

Did they tell you how your disks deteriorated so far? I just had the RFA today and I’m wondering if it works will I just not know I’m damaging my disks more?

[@mykolin4560]

All accurate and useful info. Thanks Doc. Just had an RFA today and cruisin KZbin while recovering. I’m waiting for another medical advancement so as to avoid a 5th ablation down the road. I’m fit, and everyone I share my back condition with are surprised (I put on a good face so the constant agony doesn’t consume me). And yes, regarding the PT - I stand beside your statements. Most clinics are quick to hand out exercises and send me on my way with a printout without much consideration to my age, abilities, current physical conditioning and long term wellness. All this to say, I hope others in my shoes read this and get some validation. Thx Doc

[@karinbrown-barrios4577]

I have all three of those problems you mentioned I had my nerves burned twice or three times now I need disk surgery. I was supposed to get disc replacement but now the surgeon wants to do the intercept procedure which is burning all the nerves inside the disk itself and I don't know if it's going to work I'm not sure it's better than getting a disc replacement?

[@Todude25]

They have been a game changer for the positive for my lower back. Make no mistake the nerve finds its way back (never the same pathways)

[@cmb3915]

Thank you for the good info!

[@applenyc5300]

I had neuropathic pain after this. Amd suffering from it now. DON'T do it folks!

[@epmanualphysicaltherapy]

Sorry to hear this Apple NYC :-(

[@justice2255]

You are NOT a spinal surgeon. If patients need you, you will reap the rewards. Too many of us tried your way with 0 results. We are suicidal. It is documented that it lasts up to 5 or 6 years. I would suggest both Rhizitomy and therapy. You cannot know what this pain is like. We live in a bed all day long and our family members hate us, accuse us of being lazy, of being worthless. Muscle imbalance? I have screws in my back from a failed spinal fusion in L4 -5. Because I cannot work, I have NO HEALTH INSURANCE. I can't pay for you or a spinal surgeon. Im very disappointed that you would suggest not having this Rhizotomy calling us lazy for not withstanding the pain of your therapy. I would not wish this pain on anyone. It goes from my back butt thigh leg to my ankle. I have to leave law school after my first very successful year. I wanted to help abused children.

[@epmanualphysicaltherapy]

Hey Justice, It sounds like you are a great candidate for RFA procedure based on your situation. We sincerely hope you get out of pain so you can back to Law school and pursuing your hopes and dreams. We have seen too many people have bad results from this and leave themselves in worse shape afterwards in their back. So for some people this would be the right thing to do.

[@kyongkim8139]

I am an interventional pain physician over 20 years. I value the importance of physical therapy for any chronic pain patient and highly recommended even before and after interventional treatment. However, there is no conclusive study that showed lumbar instability after RF ablation of medial branch nerves. Only study has done so far is small study for spondylolisthesis and showeed there is no worsening on spondylolisthesis on patient who had RFA vs no RFA treated patient. This is an excellent example of no lumbar instability from RFA and no weakness of multifidus muscle as you assumed. Lumbosacral structure is, as you mentioned, very complex structure which supported by multiple muscle groups including multifidus. So assuming that RFA causes lumbar instability is unfounded, yet continues to assume by others health professionals. Please do not propogate non-scientific truth to public which may resulted in depriving the appropriate treatment options for patient with chronic low back pain.

[@epmanualphysicaltherapy]

Thanks for sharing your perspective Kyong! You're absolutely right in writing, "...there is no conclusive study that showed lumbar instability after RF ablation of medial branch nerves. Only study has done so far is small study for spondylolisthesis..." And that is the point that Dr. David is raising at 5:00 in this video about the lack of research in the area. The lack of strong empirical data on the topic is not a strong reason to believe that it's not possible to have lumbar instability from an RF procedure to the medial branch of the lumbar spine. The more accurate thing to say to a patient would be, "We don't have strong research that shows what the side effects on lumbar stability are from an RFA procedure. There's a chance it might have zero effect on lumbar stability and there's a chance that it might severely affect lumbar stability. So far, we only have a small study...which is not enough to prove cause and effect. More research is needed for this." So could it be that writing that the SMALL study that showed no worsening of lumbar instability of a spondylolisthesis patient is an unfounded assumption that radiofrequency ablation procedures for a variety of chronic lumbar pain conditions would be beneficial?....that's something to think about! What about all the research tied to pain relief by exercising the muscles that control the lumbar spine? There's definitely more than 1 small study for that! But never mind the research at this point since we don't have enough of it to have certainty and are left to assumptions, let's just think about the function of the deep lumbar muscles. It stands to reason critically that the potential loss of function of these muscles puts patients at risk of depriving them of appropriate rehabilitation options for chronic lower back pain because they would not be able to use the full potential of these muscles. Medical beliefs can often be held onto much stronger than accurate, critical thinking about the situation. Dr. Semmelweis's story about handwashing is a clear example of this. Dr. David made a video summarizing Dr. Semmelweis's connection to handwashing and how he was killed over it because the medical community rejected his information due to a lack of "scientific basis". It wasn't until decades after he died (was killed) that handwashing became normal mainstream medical practice. Dr. Semmelweis never acquiesced but held onto his critical reasoning about how death rates were connected to whether or not surgeons washed their hands. See the video here: "You CAN Prevent Surgery Naturally: Why Some Healthcare Professionals Won't Tell You" kzbin.info/www/bejne/jGq9aZyviN-Jf5o Handwashing is so normal now that it seems silly now to think that the medical community once so staunchly opposed it. But it begs the question "What is being done in medicine at this time that in 20, 50, or 100 years will seem silly?" Could burning spinal nerves possibly be one of those things?

[@Hydrich93]

Aren’t MRI’s supposed to show in great detail if anything is wrong. How could my orthopedic doctor miss a pinched nerve in the lower region then refer me to a pain specialist for a RFA when it wasn’t necessary. My second MRI SHOWED that it was a pinched nerve just like the first MRI. That cost me a lot of money to say the least. Is this incompetence or malpractice?

[@batman-sr2px]

So if mutifidus weakness can happen with lumbar RFA what is a possible risk of weakness with cervical RFA?

[@batman-sr2px]

​​@@epmanualphysicaltherapyif lumbar RFA can cause weakness of mutifdus then what can cervical and thoracic RFA cause weakness of?

[@nadakodsia2635]

Thank you for your explanations & info, very informative. 👍

[@oppothumbs1]

PT is so important to try. This has some good advice but I think RFA has proven pretty successful though seeing a specialist, going through PT and then finally going under the knife in a year or two is probably better if the pain is not alleviating. Also RFA in the last few years has improved and can spot the right area to inject and also go deeper to cut a nerve. If you try RFA once and the pain returns, it is best to move on. This is the only guy on Google or KZbin who has spoken out against this but hey what possible reason lol would he have as a Physical Therapist to speak out against this? I can't think of one. A 2010 study I read: "Low back pain and sciatica due to lumbar disk herniation are relatively common conditions for which numerous treatment options have been proposed, including physical therapy and SNRB injections. There is a need for research examining the most effective treatment options and the best strategies for sequencing potentially viable treatments. The results of this pilot study failed to show that physical therapy interventions intended to centralize symptoms after SNRBs were more beneficial than SNRBs alone". I have had physical therapy and sometimes it helps some, sometimes not. Also, SOME OF THE THERAPIST JUST GIVE YOU THE SAME OLD ROUTINES AND NEVER THINK OUTSIDE THE BOX. I swear I have come up with my own exercises and they help more and seemed unlike what exercises were being prescribed. After hearing them, the PTs often agree and add them to my session. It's so damn obvious to me that so often PT fails and the studies on its benefits are lacking. Also, perhaps PTs are afraid of being sued if they go outside the regular prescribed exercises.

[@JCJ34]

I had this procedure done today. I've had chronic back pain for quite a while due to an old high school injury that flared up randomly. My lower back, buttocks, and most of my right ached and felt weak all the time. My quality of life was suffering. When I awoke in recovery, I was flat on my back in the bed. That was the first time I was able to do that without excruciating pain. I left the hospital with absolutely no pain, just some mild discomfort from where the nerves were burnt. My excruciating radiating back pain is gone. I know the everyone's experience isn't and won't be the same. I know the underlying issue is still present, but I absolutely could not be happier with the results I've received. Hell, I'm 36 years old, and I feel like crying due to the relief.

[@Leedog415]

Going to get this treatment in several weeks! Can’t wait

[@JCJ34]

@@Leedog415 Back pain is no joke. I hope it works for you. Wishing you the best.

[@072010SIGHT]

Did your ablation work very well long term? Some say there is bad pain the first couple of weeks. Did you experience that?

[@JCJ34]

@@072010SIGHT I haven't had any pain since I had it done. It's been 8 months now, and the only time I've felt any discomfort is when I've done too much, lifting heavy, doing carpentry work, etc.

[@sandytotox9029]

Juts had this procedure done yesterday, i read your story and mine is very similar, except that i'm 49 years old,,,, finger crossed for a positiv result in couples of weeks and for a long perdiod

[@dennismoore8351]

I had an RFA two days ago. I did physical therapy 5 years ago and it didn't work. My conditions have worsened over time after a T-bone accident. I tried several medications without relief. My PCP sent me to a spine specialist and she did two test injections of lidocaine. It helped slightly so she suggested the RFA. My insurance company told her I needed to see a physical therapist before it. I went to two visits and was out of work, unpaid, for two days each time. My conditions are a forty year old injury, arthritis, bone spurs, compression of L5to L2 and spinal stenosis. I also , for a couple months, been having episodes of balancecloss. It worsened severely after the physical therapist thumbpressed my spine at my original injury site. I have not had so much instant pai like that in a long time. I have been able to walk better the last two days but I still get pain bending over or turning my torso.

[@kevinmetcalf6371]

Thank you for this HELPFUL VIDEO

[@epmanualphysicaltherapy]

Hi Kevin! 👋 We are thrilled that you found our video so helpful! 🙌 Thank you for all your kind words! 🧡

[@syndromeee]

How will strengthening lower back and abdominal muscles alleviate pain associated with degenerative disc disease and disc herniation? The muscles can’t make the disc regrow or “put the jelly back in the donut.”

[@johnsalisbury3768]

Stability, a strong core with healthy movement patterns and posture will help relieve some pressure off the discs. Will not regenerate the discs, but can help reduce the pain and instability symptoms. Will not regenerate disc material, but will reduce further progression of degeneration.

[@Sylvaniaohio]

All of my shots didn't work for back.

[@NikolaEngineering]

I had this 2 years ago. Really worked pretty well. I'm fit, do a lot of competitive cycling. Just had a repeat procedure 10 days ago. Still pretty sore.

[@salvadorsepulveda6415]

Thank you, your information knowledge is enlightening. Blessings 🙏

[@epmanualphysicaltherapy]

You're welcome Salvador!!!

[@djrc5228]

Never get RFA? C'mon man, you should never give out advice like that. RFA on 4 spots of my lower facet joints have given me a new lease on life. No more lumbar pain and no regrets what so ever. Next I'm looking at sciatic RFA to rid the pain in buttocks and hips. Also to relieve numb and burning sensation in a couple of toes. If I listened to you, I would be in pain for the rest of my l;ife.

[@epmanualphysicaltherapy]

Hey DJ RC, you're lucky that you've had a good benefit so far. Be wary however...if you're not addressing the root problem of your back pain and sciatica it's likely to come back eventually. And you may not have normal function of the muscles you need to get stronger to address the root problem. Cheers to great back health!!!

[@anneheininger889]

This guy is a PT. He would rather have you see him a few times a week. Every time I went to PT I ended up with additional injuries. This video is simply a sales pitch.

[@Lizziern911]

Same here. I am an ER RN. I can not work without this. Have been a trainer too- didn’t help pain to be so strong.

[@jonathongutierrez9889]

I’m with you DJ. I have stenosis in 4 of my vertebra and I was losing all hope in life. These things gave me a second chance and I’m able to get back to physical activity and working out my core again. It’s been a blessing.

[@oppothumbs1]

@@epmanualphysicaltherapy Yes you are right to address the root problem and exercise is so important. But don't oversell PT (do you have unbiased studies or surveys?) and next time don't speak out against RFA so strongly. It will give you more cred too. Just say get the PT first. But trying different P Therapists is usually not going to help unless you have studies that show that.

[@smittysmeee]

Just so folks know, most insurance companies (including Medicare) require 2 temporary nerve blocks be performed before the actual ablation to help ensure the ablation will resolve your back pain before it is done. If you do not feel what you perceive to be at least 80% pain relief from the nerve blocks, most insurance companies will not authorize the ablation. The more you know! 🌈🌟

[@lindamorris9483]

I had an RFA done in my lower spine. It caused me to lose control of my bladder. I was told it should last a year or more. I was really glad the nerves grew back quickly in 3 months, and recover bladder control. I will never have it done again.

[@epmanualphysicaltherapy]

So sorry to hear this Linda :-( This happens much more than we'd like to hear and it's rarely talked about. We're glad that you've recovered control!

[@Triciadean7777]

Oh nooooo

[@tinahunter8453]

Nope that did it for me I not going to do it, thank you for the heads up!

[@c.williams3480]

Omg! That scares me!

[@starlightzz1480]

I already have bladder problems due to my herniated disc and my doctor just told me they will try this next. I am scared now. Idk if I should do it.

[@rlknight57]

Of course he is going to recommend PT rather than RFA because he is a PT therapist.

[@Jack.Yi.]

Simple comment here...I have chronic back pain and I have been to PT while I was mesical leave, it was wasting time and money. PT is for seniors, insurance claim...It does not help people who has chronic spine problem. Also, PT trainer can't judge Orthopedic procedure. I would ask you to shut up.

[@zunyhassey4142]

Thanks so much for this information. I was about to make an appointment to consult about this procedure. I am desperate to find relief! I wish you were here in California 🙏🏻.

[@SharonPryor-hg9oj]

Had my 3rd on done today. I'm doing what I can to avoid major surgery.

[@believeNlove]

What an arrogant video! "Why You Should NEVER Get A Radiofrequency Ablation For Chronic Back Pain" is a completely misleading title considering the last bit of the presentation is a discussion of situations where RFA IS appropriate. To suggest a patient try different PTs, until they find one that fixes their issue is also nonsensical. Most people are limited to the physical therapists approved by insurance and the number of visits their doctor/insurance coverage prescribe/allow. PT isn't so cheap that most of us can experiment until we find the 'one' best suited for our problem, or even one that specializes in non-post-surgical cases! In my case, I was diagnosed with arthritis in my lumbar spine, some stenosis, herniation and bone spurs. I was allowed 12 week of PT and saw zero improvement. Medication was of little to no help. The nerve blocks done to check my candidacy for RFA each gave me two days of complete relief. The first RFA gave me several pain free months. Sadly the 2nd RFA has been ineffective to so far, which is why I am on KZbin looking for other options. I think you should, at minimum, change the title of this video to something designed NOT to frighten people suffering from lower back pain. It's irresponsible AND arrogant.

[@infectdiseaseepidemiology2599]

I have real problems with somebody with a DPT calling themselves “doctor.” Granted, I have an MD and a PhD. But a DPT is not even a PhD with a strong research background. It is the default PT degree. Many pts are confused when a PT is introduced as “Dr”, naively not knowing that they are not physicians. Between PharmD (doctor of pharmacy-the default degree for those dispensing pills), DNPs, and all the other purpirted “doctorates,” it simply confuses patients. Of course despite my real doctoral degrees, I introduce myself by my name, and not “Dr”. In Germany I am introduced as Herr Dr. Dr. Professor.

[@nicoleheatherington4365]

You seem highly focused on titles and letting us know that in your opinion your titles in Germany are superior. But a PhD or MD is not an expert in physical therapy and the clinician in the video has the academic background under the laws of US entitling him to the designation of “Doctor.” It is the highest terminal degree in his field of physical therapy. Additionally, and perhaps more importantly, the speaker has not only the academic background but years of clinical experience. Accordingly , it appears that he is well qualified to offer his expert opinion on the subject matter and what he has to say is well worth considering by viewers.

[@xtantaudio1]

Definitely all good information. I dont care what the procedure is called, or if it is or is not classified as surgery, as long as it takes away the pain that I have that is making me not able to function at 40 years old. I have a failed disc in my lower spine, causing the "crushing" of my sciatic nerve. My back is strong, but I just cant take the pain anymore.

[@Katsummer777]

Hi a question for you. What do you think of doing this on C 6 and C7 in the neck? Is it safe for that or the same as the lower? I have been on strong painkillers and do not want to stay on them so they’re offering me this as an option and I’m trying to find out whether it’s a safe thing to do. Thank you for your time.

[@johnvaillancourt8978]

Thank you

[@carendembowski6860]

He's telling the truth. I had it done for like 2yrs I lost the feelings in my legs twice. One Dr told me to stop because I coulid become paralyzed . I stopped doing it and when I walk my back falls forward. Very dangerous, I wish I never did it.

[@KevinLopez-vf1wk]

Opinion only. Physical Therapists are not Doctors. This guy could be better help by not posting opinions. RFA has helped numerous patients.

[@epmanualphysicaltherapy]

Hey Kevin, yes this is definitely an opinion. As physical therapists, we've seen sooo many people end up worse afterward. The risk vs. reward potential for radiofrequency ablation procedures for lower back pain is very concerning and so many patients don't even know. Just check the comments here to see how many people have had bad experiences and would have liked to have known this going into the decision. At the end of the day, everyone is left to make the best decision about their specific health situation with the information available. The perspective presented in this video is rarely ever mentioned.

[@FreedomLee721]

How do you feel about Intracept?

[@cherylradabaugh2720]

I've done lots of PT for my back ,legs ,had ablation done on both sides of my lumbar . Now I'm in constant pain ,have muscle spasms ,have trouble with my right hip and leg wanting to just give out on me.when I'm trying to walk . I was in pain 24/7 before ,but now unless I lay on the floor ,that's about the only way I get a bit of relief .

[@lauramorelliconway4556]

Hi I had an RFA 5 years ago. It was a nagging pain that kept me from sitting comfortably, lying on my right side, walking. Ive done PT. Twice for this. I had the RFA and it did help but not 100%. In the mean time, the nagging pain just came back afewmonths ago meaning the nerves probably did grow back? so I am having another RFA.

[@WaterBored-kf2ci]

I've had about 10 or more RFAs since 2013 for a low back injury I suffered while in the 82nd airborne. Never had a single issue, in fact, it actually alleviates pain for 6 to 8 months. I don't take a sedative nor take their option of local anesthesia for the procedure. I will continue to get RFAs since my next option is back surgery, specifically a disk fusion or diskectomy.

[@WaterBored-kf2ci]

Each of my RFAs have been 3 on one side, 3 on the other. It works and I'm appreciative for such minimal invasive options outside of actual back surgery

[@epmanualphysicaltherapy]

Hey there! We are glad to hear that the RFA surgeries have been very successful for you! This procedure can absolutely help manage the pain for many people. It is important to point out that the procedure does not actually fix the problem though. The alleviation of pain is great, but if you fix the problem while you are relatively pain free, you may not have to continue to get the procedure done. We have some great content available to help get your back on track to heal. If you are interested in learning how to fix the root problem, we have this great playlist of videos that may be able to help get even more long-term relief: “Lumbar Spinal Stenosis Help” kzbin.info/aero/PLJVIPiFvv1mYxifSEM8bNacVpyTmc3_Ys

[@HoboMinerals]

I’m nervous about getting it… I’ve done the physical therapy, and wasn’t getting the results she wanted, and so went on this long journey of trying to find pain relief without drugs…

[@calivalley9056]

I just had this done on my upper back, the first three times they just injected numbing drugs (nerve block test) and it seemed to work but when I the RFA was done it didn’t work. I suffer from constant pain when sitting and standing, then lose strength to stand up-rite over time. I have to lay down, recline or hold my upper body up, almost like traction. I’m in my late 40s, this started in my mid 30’s, it sucks.

[@karynray4297]

The 1st time I had this done it took all the pain away for 13 years. This is the second time I've had it done and this time my back is worse

[@epmanualphysicaltherapy]

Sorry to hear this Karyn Ray :-( Looks like it's time to start treating the root of the problem. You've got to address the muscle imbalances. That's what doctors aren't trained to treat. They just like to give medicine and procedures. Here are some playlists that might help you out: "Herniated Disc Help" kzbin.info/aero/PLJVIPiFvv1mYk59Nn77n3t_dh4DeJaWVR "Degenerative Disc Help" kzbin.info/aero/PLJVIPiFvv1mbqXHL0rt1CuGITt1xOatoB “Lumbar Spinal Stenosis Help” kzbin.info/aero/PLJVIPiFvv1mYxifSEM8bNacVpyTmc3_Ys If you're looking for a more comprehensive exercise program for back problems, then you've got to learn more about our 28 Day Back Health & Wellness Boost Program. It's a 100% online and on-demand program for improving back health. It's packed with exercises, advice and coaching from Dr. David. You can learn more about it here: www.epmanualphysicaltherapy.com/back-health

[@balvirsidhu343]

Dr g please tell me about RFA of trigeminal problm of nose Is good treatment or not according u and what is good treatment of trigeminal problm

[@littletime100]

I have spinal stenosis and they are wanting to do this, Is this the same as a nerve block because I was told when I had a total hip replacement to not ever get another nerve block?

[@timscoviac]

I have severe chronic back pain in my thoracic area from a result of a terrible car accident or possibly the unguided epidural I received in intensive care that was placed in the wrong area. Regardless I was in so much pain I couldn’t even get out of bed or barely sleep because it felt like I had a torch up to my back, and medication injections were not lasting long but the rfa do last and give me a lot of relief, with my case there’s nothing wrong my joints or discs, it’s something nerve related that’s causing me so much pain, possibly arachnoiditis or myofascial so the rfa isn’t leaving anything untreated to get worse

[@morganschiller2288]

It sounds like radiculopathy from spinal stenosis. The only things that will work is getting the pressure off the nerve or doing the RFA.

[@williambyer4442]

I can't find the link to this program this 28 day program you keep talking about! I can't find the link! Where is it?!

[@epmanualphysicaltherapy]

Hey William! Here is the link you're looking for: www.epmanualphysicaltherapy.com/back-health

[@Famoustoast]

I have two herniated disc, stenosis and they recommended RFA but I’m on the fence about it because eventually I will need a fusion. Why wouldn’t I get the fusion now instead of prolonging it?

[@vcash1112]

Hiw can you get the muscle strong if the nerve is getting hit and causing the muscle to guard?

[@stephenstarling]

I don’t have the words to express how low opinion I have of you opinion

[@rtk7233]

You missed on important part; the nerve is not "burned" at first. The initial treatment is a numbing agent on the nerves in the area, that way they pinpoint the nerve. They don't just go in and burn the nerve. How long do you go to PT before realizing it's not going to work.

[@danieljaramillo87]

Thank you so much, that bit of information was very helpful. Thank you! I'm one person whom loves to work out. I was just involved in a rear accident in which case it totalled my car and has left me in pain. I push through it but sometimes pay next being really sore. I've just had a medial branch block. I'm going to give time, then continue my workouts. ❤

[@epmanualphysicaltherapy]

Hey Daniel! We are truly sorry to hear that a car accident left you with chronic back pain and has not allowed you to exercise which you love 😕. Our suggestion is to definitely give your body enough time to heal and recover but once you are feeling more confident you can consider implementing the advice found in the following playlist: "Back Pain Exercises & Stretches" kzbin.info/aero/PLJVIPiFvv1mYkrbLk-F5KsUcHPEkdDF-u We wish you the best on the road to recovery! 🙌

[@bearsmartdurango]

Great ad, but PT did jack squat for my low back pain and no amount ever would. Doing basivertebral nerve abaltion soon.

[@robertottwell605]

I had rfa treatment and with a good dr I got complete relief for over a year before that time I could not walk and needed a walker to get around. Since then I have lost 107 pounds it changed my life. The Physical therapist wants you to keep coming to the physical therapy office and doing physical therapy along with the chiropractor. They want you to keep coming to the office.

[@resistor8735]

I have severe thoracic back pain at 2 sites. I used RFA for 3 times over 4 years and got a small amount of relief for a very short time. It has made things worse overall.

[@phoebeanthony8094]

EPIC FAIL

[@vcash1112]

​@@phoebeanthony8094 Maybe they didn't get the right nerve..

[@gonzagnr2]

I have had 4 or 5 RFAs done in my thoracic spine t5-t6-t7 Absolute relief for almost a year each time. Is the only thing that has worked for my facet pain.

[@sunshinearmstrong-hanson-cj1ot]

It is misleading to call yourself a doctor, in a medical issues video, as people will think you are an MD. Just because you have a doctorate, when you're talking about medical issues, in a public video, it will be misleading to many people and they will assume you are an MD. RFA has helped many people, and while it is certainly not for everybody, it helps many people.

[@venomfastback]

I have had chronic back pain for for 20 years. I have had 5 back surgeries and they are talking about doing intracept. What do you think about that surgery?

[@bahaaalrawi42]

So what do you recommend I do for my chronic low back pain due to facet joint arthrosis?

[@lane2063]

Find a competent spine surgeon who has a relationship with a pain management doctor. I have this combination of providers and they work together to give me the best treatments and outcomes possible. PT or spinal manipulation isn’t the answer.

[@morganschiller2288]

A TLIF unless you can get a lumbar disc replacement

[@lane2063]

@@morganschiller2288 Lumbar disc replacement isn’t a viable option at this time. TLIF will be combined with a PLIF and is a major surgery. I’ve had multiple surgeries; ALIF with PLIF, TLIF with PLIF, and XLIF with PLIF. My entire lumbar spine is fused.

[@narmypara100]

Ok so had mine around 8 weeks ago ,and the results are amazing each few days the pain is decreasing to the point I can now stand straight and lean backwards 🙏I'm walking climbing and doing everything I couldn't do before the RFA ,I was skeptical to have it done and a bit scared but I'm pleased I did because it's changed my life ,once it comes back il have it done again and then surgery ..I'm happy with the whole thing altho the first 3 weeks I was twice as worse

[@Themarketplacegirl]

My husband is military and has 2 bulging discs and a bulging discs. This procedure is what they recommended. (We did not want to have back surgery as my husband is only 40)Do you have any recommendations for him or do you think ablation is a good option?

[@Lalakis]

Someone should educate yourself about a) pulsed RF which targets only the c-fibers non-myelinated that transfer pain b) continuous RF which tarrget the branch to the facet but does not touch the medial branch of posterior ramus.c) the majority of patients getting the rfa has already received PT for long periods of time with no effect d) the patients getting Rfa must have received at least 2 times diagnostic block either in the facet itself ( the capsule) or the medial branch with good results that make them candidate for rfa

[@morganschiller2288]

Nice! I’m a neurophysiologist and its nice to see someone on here who is intelligent. The folks who are experiencing severe cord compression are the ones that are scary. Conservative treatment has its place. But when it comes time for surgical intervention it has to get done. Folks don’t understand when you have a loss in disc height and develop stenosis there is no going back you need a fusion or disc replacement. No amount of PT or injections are going to help.

[@johns1577]

An Interventional Radiologist is offering pudendal nerve cryoablation to treat my severe left scrotal pain. I've had 2 100% successful nerve blocks done at the ischial spine. He wants to do a block at the Alcock's Canal, then treat there. But that's distal to my previous blocks AND to the most common entrapment location for that nerve - the spot where the sacrospinus and sacrotuberous ligaments cross. Apparently all ablation types get done that way. This doesn't make sense to me and I can't talk to this doctor until the day I fly there for the block. What am I missing?

[@christopherkongevold8973]

Hello, Must say I love your videos. Many good exercises you recommend. I was injured in 2019 when a fence hit me in the neck. No findings on MRI. An enormous amount of pain in the neck, during physical activity it gets much worse and I can become dizzy. The neck is always stiff and painful. The pain is around C5, C6. But I was wondering if you could answer a couple of simple questions about Radiofrequency Ablation for the neck. 1. Why should I not do it? 2. What are the negative effects after having a Radiofrequency Ablation for the neck? 3. What else can I do? 4. I have done a small test off nerve blockade earlier and had a good effect from it for a few hours Thank you a lot

[@724599]

I don't see the 28 day course sign up, can you send me the link?

[@epmanualphysicaltherapy]

Hey Wray, Absolutely! This is our 28 Day Back Health & Wellness Boost Program. It's a 100% online and on-demand program for improving back health. It's packed with exercises, advice and coaching from Dr. David. You can learn more about it here: “28 Day Back Health & Wellness Boost Program” www.epmanualphysicaltherapy.com/back-health We'd love to hear how you are doing as you progress!🙌

[@Anna_Bella84]

I wish I had seen a month ago I got this done with nerve blocks aswell & I am worse than I was before I went in. My pain was a 10/10 for a whole week I had to spend 2 days in hospital . The pain is still so bad I can’t walk properly & I’m taking way more pain killers now than was as before hand. I wish I never did this.

[@epmanualphysicaltherapy]

Sorry to hear this Bella :-( This happens much more than we wish it did. At least now you know that it's probably not the best treatment for you!

[@PraiseHim123]

I'm so sorry you're going through this. I was thinking about doing my lower back, but now that I see your comment and others, I don't. What do you think went wrong in your case?

[@noname-ye7zj]

My buddy had it done, he said he felt great for a whole year, he's going back for another treatment m I'm seriously considering it. I worked with him for a long time and before this he was in a lot of pain ​@PraiseHim123

[@BlueSkiesSunnyDays]

I have a couple disks bulging and I have nerve impingement, I had a couple medial branch blocks so now I’m going to get RFA

[@vcash1112]

How did it go?

[@HeliRy]

RFA changed my life for the better. It got me off the pain meds and stopped me being a prisoner in my own body. I now get it done every 6 months or so. Not gonna lie, the procedure hurts like a mother f**ker. It’s not for the feint of heart nor for people with manageable pain. If you don’t have debilitating pain then this probably isn’t worth it for you. But for me I will happily take 15 minutes of blinding pain, for 6 months of general relief and mobility.

[@timothyj1966]

I just had this done near SI Joint - bad back pain...for three years... Surgery not an option 3 discs slipped..... Had it done 10 days ago very sore still from Procedure... but did you notice this as well before you got relief ?

[@HeliRy]

@@timothyj1966 Sometimes yes. This last one had me feeling like I’d been kicked in the spine by a horse for a few weeks lol. Other times the pain from the procedure itself is gone within 48 hours. And now two months after, I’m bouncing on the trampoline with my son and doing jumprope exercises every other day 😃

[@PouchMaster]

@@HeliRy Hi there! I had RFA 3 weeks ago for my Degenerative Disc Disease. It's been 3 weeks of hell worse than before. Did you go through this?

[@Chicag0sMMA]

That's wild. Mine did not hurt at all.

[@timothyj1966]

I just tried it again near SI Joint in July 2023... didn't help this time at all!

[@Sydroo1969]

I had one that didn't even work for three months. The pain came back worse than before RFA. That was my last step before surgery. Now I have spinal surgery next. Also found out I was born without S1 and S2. Never knew that until neurologist told me. I'm in my mid 50s.

[@tjmac4256]

As a person with ten bad discs,stenosis,spondylosis and severe bilateral foremenal narrowing I can tell you this procedure does reduce pain and lessens the use of nerve pain meds and opioids.personally I refuse to get disc fusion surgeries as all the discs in my neck except c1 and all the lumbar discs have issues and if I get them all repaired I will have the flexibility of a broom

[@jonathonpaxson8829]

I have degenerative spondylosis and had cortisone shots in my lower facet joints which did seem to help somewhat but only temporarily and not throughout my whole lower back. I did spend a month on PT but didn't seem to make enough progress to satisfy the doctors and workers comp. For reference I worked the last 5 years in a warehouse where we are expected to move between 1000 and 1500 cases per night with each case weighing between 10 and 80 lbs and I have been moderately active outside of work between running and disc golf.

[@timschannel910]

I had a bulging disc in L4 L5 and S1. I have tried pain pills and physical therapy and heat and ice. I tried the shocker on my back. I have done massage. I am going to have this done next week. I have been in pain for years. They also said I can have r/arthritis in my back plus the nerve being touched a little but I have to try something. I have done it all but this and surgery.

[@epmanualphysicaltherapy]

Hey Tim, sorry to hear about your bulging L4/5 and L5/S1 discs :-( We hope you can get some relief from your back pain with the RFA procedure. Have you tried our 28 Day Back Health & Wellness Program? It's a comprehensive exercise program that addresses the root of back problems. It's a 100% online and on-demand program for improving back health. It's packed with exercises, advice and coaching from Dr. David. You can learn more about it here: www.epmanualphysicaltherapy.com/back-health

[@VictorHernandez-qt2xx]

Hi Tim, hope you are well. Did you get your procedure?

[@mohankumarpissay4059]

Hi tim, is the procedure done?

[@user-uz9vv1hp9o]

Is there something else for T9-10 disc herniation. 4 neurosurgeons and orthopedics have refused surgery sine they would need to go through the sternum and back. Surgery is only an option if paralysis were to happen or other sever loss of mobility. Thank you!

[@ibbyzimmerman7420]

I have done epidurals, medial branch blocks and steroid injections. My issue is t8-t9. Thinking about doing the RFA in a couple of weeks

[@cherubfoxx]

I had it done a few monthsago...both sides. Increase in urination noticed, as well as pain down one leg intensifying. The same side ankle is hurting worse each day and causing difficulty walking.

[@epmanualphysicaltherapy]

Sorry to hear this cherubfoxx :-( We hope you can get back to normal as fast as possible!

[@ChefHaitistar]

I have the same also after my last one my right leg feels numb

[@phoebeanthony8094]

I am having more frequency as well but thought it couod be something else

[@veganjem]

very good info! I was recommended this for my neck pain. Chiropractic made it worse, so did physical therapy. So RFA was recommended.. I am scared of injections and drugs. I also cant fathom the idea of burning my nerves.. I am just going to stay as is for now.

[@nrp5791]

I'm getting a Cervical C6 C7 nerve block. So far I have gotten good feedback that it can work if done correctly and in the source area of your pain. It's actually a Diagnostic Test towards getting an RFA which I will consider later if the Medical Branch Block works.

[@veganjem]

@@nrp5791 I hope it works for you I’m just not that brave. And keyword here is IF

[@RedbeardWildlife]

Hey buddy, I have it done every 7 months, it is night and day, it turned my entire life around, I went from crippled with 2 walkers and horrible quality of life to the ability of walking on my own, I was able to lose 100Lbs and now can play with my kids in life. It's an amazing procedure with amazing results. Have had this done every 7 months for the last 5 years, best thing that ever happen to me.

[@nrp5791]

@Vegan Gem mine worked! Just waiting on insurance to go as slow as possible to process the claim to pay their part. Then I get get the other bilateral shot on the other side.

[@sunbeamfactory5171]

@@RedbeardWildlife I completely agree. My pain is so bad that I've tried to go out for the day and ended up in the urgent care for a Toradol shot halfway through. RFA gives me a decent quality of life.

[@ashleysok4242]

I’m supposed to have a radio frequency pulsed procedure done on my c2 bilateral nerve root… is that the same thing ? I have occipital neuralgia. Ina,ready have c3 to c5 fused but it’s worse now

[@epmanualphysicaltherapy]

Oh no Ashely!!! You've got to work on getting the muscles stronger the right way! Getting the radio frequency procedure will potentially cause you to not be able to use your muscles well since they're burning nerves in the area. But it's really up to you. You might get pain relief from the procedure. You have to determine if the pain relief is worth it for you to potentially lose some muscle function that may be critical in you solving the root problem.

[@ashleysok4242]

@@epmanualphysicaltherapy oh I didn’t know that he told me it’s safe it’s not burning the nerves just little frequencies but I honestly don’t want to just try it in case it makes me worse for my occipital neuralgia

[@tammybowler]

3 physical therapists, 2 pain management dr's, chiropractor, and tons of medicines with no relief over 2 years and the rfa was the only thing left to do.

[@thestork2210]

have you done it?

[@tammybowler]

@@thestork2210 yes and it works

[@PouchMaster]

@@tammybowler It was helping me. Just had my 3rd. This time it's been 3 weeks of hell. Is this normal for you?

[@marlenederks9116]

I did physical therapy which made it hurt worse!!! Of course this guy being a PT is against RFA..I've had RFAs for over 12 years nearly every 6-8 months with extremely positive results..i have issues from my neck down to my buttocks and surgery is not an option for me. This is a personal decision for each individual and their doctor and should never be put down as a negative video!!!!

[@stephenstarling]

I hav mot tried jumping off a bridge

[@dukedumby]

I've had 12 steroid injections for 2 herniated discs and been on every med (vicodin, oxycode daily, morphie sulfate continuous release, cymbalta, lyrica, gabapentin, nucynta, effexor, wellbutrin, topamax etc) and all I can say after becoming a heroin addict is that Suboxone (burprenorphine) is extremely effective in pain control and addiction control. I had a failed L5-S1 and now have bulges and 4 heriatations from T5-S2. Thank you for your video doc, I love that you described your credentials (amazing how chiros never seem to do that) and that you've done your research. If I'm ever in El Paso, you're the the boss :)

[@raheemahmad4659]

Would cervical rhyzotomy surgery help cervical dystonia ,or would it weaken your muscles all the more ,also can you excercise after rhyzotomy to build your muscles back again ?

[@narmypara100]

I'm about to have this done on this Monday as big as I am I'm terrified ..I'm 52 long term bodybuilder mine was damaged over time with heavy weight lifting ..I'm like a zombie everyday with a cocktail of codeine pregablin and dulotetine and valium ..the quality of life is 💩I've went from a 18 stone bodybuilder to an old man over the last 6 months ..but everyone of my friends are drilling it into my head to not have it done as the nerves grow back bigger and worse . Also the procedure is so painfull ..my head's battered and I'm ready to cancel it ..but if I do I'm stuck in this horrible circle of daily pill popping and codeine addiction ..getting out of bed and off a chair I'm like someone who's 90 .what's your thoughts on this people I appreciate any feedback ..I feel like death and my life ATM isn't worth living thanks

[@howardsamuels7856]

What about DVR procedure which is more direct and longer lasting?

[@epmanualphysicaltherapy]

Hey Howard! We still would suggest focusing on getting healthier by getting stronger, fixing the underlying muscle imbalance and stretching appropriately. We are firm believers that all options should be exhausted first before having a spinal procedure. In case you need it, here is a playlist with exercises and tips you can apply to begin fixing your problem: Back Pain Exercises & Stretches kzbin.info/aero/PLJVIPiFvv1mYkrbLk-F5KsUcHPEkdDF-u You might also want to learn more about the 28-Day Back Health & Wellness Program: www.epmanualphysicaltherapy.com/back-health

[@tracykeelan8534]

Lumbar ablation affect sensory nerves. Do you have any research to support your claim that motor nerves are affected?

[@tiramisutimebitches]

Do the nerves always grow back?

[@beverlymartin5053]

Why is this on here. A physical therapist giving medical advice. When you are in pain you want to be pain free. No one option is for everyone. I'm thinking about this procedure in the future. I've been in pain since 1997.

[@epmanualphysicaltherapy]

Hey Beverly, an RFA might be right for you if you're certain you cannot improve the strength balance in your spine. Most people jump to the RFA too soon because their doctors don't know about addressing muscle imbalances. That is what tends to make the biggest difference in back pain. But if you've been dealing with this since '97, then there may be enough changes in your spine that you're beyond healing it naturally. An RFA may help in that case. Just be sure you're willing to take a greater loss in strength and coordination since the nerve that is burned may affect some of the muscles.

[@eileentaylor2392]

I am scheduled for this procedure in 2 days. The nerve blockers helped me so they felt I was a good candidate. I’m hesitant because I only had facet injections prior. I have not tried physical therapy or a chiro. I’m thinking I should at least try that first. I have less than 24 hrs to decide. I’m in so much pain at 46 and have been like this since 38. The RFA is screaming my name but I’m thinking about the long run not just a quick fix

[@epmanualphysicaltherapy]

So what did you do Eileen?! We're on the edge of our seats!!!

[@eileentaylor2392]

I went for the RFA. It hurt a bit but the procedure was no more than 45 mins. Had it done on both sides. L3,4,5, S1. I’m still in a bit of pain, but was told to wait a few weeks before I could feel results. I am scheduled for physical Therapy in 2 weeks

[@MrsEyes512]

@@eileentaylor2392 how are you feeling now??

[@eileentaylor2392]

I am still feeling good. I’m able to get around and not sore all the time. I’m enjoying more activities in life being more productive. I still feel some pain but not like prior to the RFA. I will opt to get it again once this one wears off

[@MrsEyes512]

@@eileentaylor2392 this is encouraging and I'm happy it worked for you!!!

[@KBradAdams]

Would ablation help with a Lumbar L4/L5 fusion that did not fuse or get enough bone growth? Abs and Glutes are strong unless bending forward then pain shoots through me.

[@DrHenryDimaano]

That's a very good question. Does this mean you're experiencing low lumbar pain now?.. Seems logical that you would be, if your L4-L5 fusion procedure ended up being a non-union. Sad to say though that, if low back pain is your presenting symptom following an L4-L5 fusion procedure that didn't take, this low back pain isn't going to be from your facet joints alone (if even any of it is coming from the facets joints at all). Segmental mechanical back pain from a failed fusion procedure comes from the failed fusion -- from a persistent mechanical instability which an otherwise successful fusion would've corrected. In which case, the solution to the problem would be to revise the fusion surgery to make sure it actually stabilizes that which is painfully unstable. RFA isn't even going to be a treatment consideration in this scenario. (Of course, you could try physical therapy, see if that solves the failed fusion / mechanical instability issue.)

[@KBradAdams]

@@DrHenryDimaano thanks and it’s been 2 1/2 years and has not gotten better. Bending forward causes pain. Bending back no pain which tells me not facets as well. Anytime my back or spine shifts or isn’t straight that causes the pain. Sex just lifting my hips up and sitting on the floor really hurts. I have talked about a revision with my surgeon coming in from the front! The first fusion was done from the back. Very small incision and a spacer that has subsided! Thanks for the information I am planning for something tentatively in April.

[@morganschiller2288]

Yeah they want to do an ALIF which would be a better idea. You shouldn’t be bending at the waist after a fusion. Sounds like you need to be more mindful of where your back is. Good news ALIF’s aren’t nearly as bad as a P/TLIF. I would have loved to have a L4/S1 ALIF But they were all posterior

[@KBradAdams]

@@morganschiller2288 Yeah I am scheduled for tomorrow ALIF revision of the L4/L5 and will update a video in a couple of days when I am home from the hospital.

[@KBradAdams]

@@morganschiller2288 Its been over 3 years I think I should be able to bend now! But thanks for your reply!

[@mxmark2003]

Funny i coukd barely get out of bed did PT for 6 months of wasted time i had a RFA done and i improved to about 75 percent total game changer dont let this guy talk you out of it! It is definitely worth doing!

[@ripleypipe]

Hi, my horse has bolted...after a 'nerve burning' of two lumber facet joints to relieve intermittent sciatica, three weeks later I'm in more pain than before plus the symptoms are omnipresent. I now regret my decision to have the procedure as now I'm in constant pain and whereas before I could play some gentle tennis from time to time...now I cannot play tennis...at all.

[@nateo200]

You gotta wait longeer than 3 weeks man -_-

[@ripleypipe]

Good point Nateo, however over 10 months later there has been no improvement, so I stand by what I said.@@nateo200

[@paulc5314]

I had RFA done on my C4 and C5 area and it was one of the worst decisions I ever made. It made my pain a lot worse and I am still in pain a year later. I went back to my pain doctor and and he suggested I do it again. I told him that’s not logical. Why would I repeat a procedure that made my pain worse?

[@epmanualphysicaltherapy]

Hey Paul, so sorry to hear that you had such a bad experience with RFA. We are glad you decided to not get the procedure again! We have a great playlist of videos specifically for cervical problems in case you would be interested in learning more about what you can do to help the pain. Here is a link to that: “Cervical (Neck) Stenosis Help” kzbin.info/aero/PLJVIPiFvv1mbB6MFKdws1vpjbW_jyXB5y

[@maddyplume123]

Procedure worked well for me! I’m able to work and live pain free if I have to do again one day I will

[@yvonnewayman409]

I think you should couple the RFA by seeing a Rheumatologist just to rule out or verify other possible concerns

[@swanval38]

My Internist took blood, and said the markers for rheumatoid arthritis, and therefore, he wouldn’t refer me to a rheumatologist.

[@mr.rubright4580]

I had it done about 7 to 8 years ago? Worked pretty well honest. If you have any questions please leave a comment I guess?

[@lobolonewolf8824]

I do have herniated disk and stinosis.

[@morganschiller2288]

I have been suffering with horrible pain at T5/6 for at least 25 years. While I was expecting a T5 corpectomy. I was told no, so the next option is an RFA. On good days I fee like I have a shard of glass shoved up between my scapula, rib and lung. On my worst days I fee like my limgs collapsed the pain is so intense. What’s supposed to help? PT, ice and heat? I need real relief. No amount of stretching and rolling on a ball will do anything

[@PsychologistArpit]

USE HYPERICUM 200,4 DROPS DIRECTLY ON TONGUE FOR 15 DAYS. atleast try it.

[@estherzamora2454]

My sister had this done to her neck and it helped this procedure they will do every year cause the nerves grow back I'm getting my nerves burned in my back I've had physical therapy that failed off and on for years so I'm taking my chances. I had a friend that had it done but it made her pain worse my pain Dr gave me 2 test injections to see if it will work I'm 62 years old I'll try anything to keep this pain gone so I can function

[@thestork2210]

How did it go with the 2 injection tests?

[@groovefretboard]

What’s your opinion on PRP? Stem cell?

[@epmanualphysicaltherapy]

Hey there! Many people receive benefits from PRP and stem cell treatments. However, they are not going to fix the actual problem and should be used in conjunction with the proper exercises and stretches to limit symptoms and improve function.

[@DrHenryDimaano]

Just curious though... How does physical therapy solve symptoms of a degenerative disc disease or degenerative stenosis presenting as nerve root compression, or even symptoms of degenerative facet joint disease presenting as chronic segmental back pain?.. Does strengthening the muscles reverse the degenerative process or definitively relieve the neurologic compression? Also, isn't your title quite overgeneralized? Stating that one should "never get an RFA for chronic back pain" gives the implication that RFA isn't effective at all, despite the adequate scientific medical evidence that shows that RFA works in the properly selected patient. Lastly, I've never encountered any spine doctor/surgeon who would categorize RFA as "non-surgical". It's a percutaneous procedure that falls under the general category of "minimally invasive surgery" (MIS) technique -- and its being MIS in nature has proven benefits & advantages when compared with more traditional (i.e., open) surgery approaches. MIS isn't a marketing ploy, but a modern approach to doing surgical treatment. And despite the known big advantages of MIS -- e.g., small wound, least amount of tissue destruction, very minimal post-op pain, hardly any blood loss, can be done on outpatient basis, can typically yield good results in just one go (without needing repeated clinic visits / multiple sessions / maneuvers done over weeks on end) -- it's still categorized as surgery. So it makes me wonder who these people are, those whom you say don't refer to percutaneous RFA as being surgical in nature.

[@morganschiller2288]

I’m wondering how PT, traction tables and standing on a wobble board reverses a loss in disc height.

[@Graubnerj]

I am not a doctor and I won’t pretend to know exactly what I’m talking about. But more importantly I am a 90% disabled veteran who’s has had 4 back radio frequency ablation’s at this time. I will definitely say that after the procedure within a day I usually feel no pain to very little which goes away. I usually have 100% relief of pain for almost a year if not a full year before I get the procedure again to re-burn the nerve that has grown back. So this Doctor Who is saying nothing nerves does not go back. I’m not sure he is correct because why would the paint come back after a year if the nerve is not going back to bring the pain or tell my brain that my back is now hurting again? The first time I have this procedure was at UC Irvine, although I was considered a veteran outpatient from the VA. The second and third time I had it at UC Irvine. My last one was today and it was at the VA in Long Beach I am very comfortable, but my back hurts a little bit as of right now.

[@suewade3970]

Why when I think I'm gona be fixed I come across a video like this dam it when my back pain is inflamed it's the worse ever I can't even move sitdown or lay down I had a cortisone shot it helped for awhile but pain came back so what do you recommend then? Do you back pain do you know how painful it gets????

[@epmanualphysicaltherapy]

Hey Sue! We understand how frustrating and painful back pain can be! And we are so sorry that you are having to go through this. We have a lot of great content designed to help people stay away from some of these procedures if you would like to learn more. Here is a link to our playlist for low back pain that may be able to help: “Lumbar Spinal Stenosis Help” kzbin.info/aero/PLJVIPiFvv1mYxifSEM8bNacVpyTmc3_Ys

[@darlamorales8843]

I have Osteoarthritis in my lower back, will Physicals Therapy help it.

[@epmanualphysicaltherapy]

Hi Darla, It depends on the physical therapist. Many PTs are trained to focus on post-surgery recovery, so they might not always address the root cause of the issue. This isn't their fault; it's just that traditional training often emphasizes older techniques and doesn't always include newer, innovative methods. That's where our approach is different. Dr. David's methods are specialized and may not align with traditional or commonly practiced approaches within the field of physical therapy. As a result, it can be challenging to find therapists who follow similar methods. You might find it helpful to visit the website of the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT). They have a "Find a Fellow" search feature that can assist you in locating physical therapists who have advanced training and specialization in manual therapy techniques similar to those practiced by Dr. David. Here is the link to their search tool: aaompt.org/Main/Public_Resources/Find-A-Fellow/Main/Member_Resources/Find-A-Fellow.aspx?hkey=108c9a56-f793-45e4-b3ed-cefe5d871a94 In the meantime, we do have a back arthritis help playlist you might find helpful. You can access it here: “Back Arthritis Help” kzbin.info/aero/PLJVIPiFvv1maO8mjLabmoW2hgcx1XG2jH We hope you found this information helpful. We'd love to hear how you are doing as you progress.🙌 Please take care!