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

[@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.

[@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

[@munja3727]

How are you now ? Is it worh to do ?

[@philipwoodford6286]

I’ve just had it for the third time -I’m glad it’s working for you I can’t believe that I’m walking without a can today or using a wheelchair which I’ve needed too!

[@rgj406]

Thats great

[@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.

[@Daisylynnetoad]

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?

[@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!

[@MyDailyAdventures-andLaughs]

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?

[@workinghorse]

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?

[@BuckeyeOne93]

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?

[@CYI-v4o]

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.

[@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.

[@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

[@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!!!

[@CricutforNewbies]

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.

[@pj-mn4uj]

I had this procedure in 2018 and now it is beginning to wear off. My pain level went from a 8 to about a 2. Now my pain is at a 6.. The procedure ...It was life changing. I felt better immediately after the surgery in 2018. Thank God I had no negative side effects. I have a consult to have the procedure done again. Praying all will go well again. If lasted 6 years almost pain free.

[@clayton2500]

That’s incredible!

[@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.

[@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)

[@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! 🌈🌟

[@brendacrum2388]

Had 1st ablation on left side of my neck today Oct 25, 2024 prayed first for good dr. God gave me a good one. Gave me 2 pills 1 for pain 1 for relaxation. Procedure went great no pain. Can't wait to have right side done in 2 weeks. Thank you Lord

[@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.

[@user-fq1xh7bg7gJoe_Frisina]

70 year old here. Lumbar spinal stenosis, degenerative discs, spndylolithesis. I had bone spurs removed at L4- L5. The details you give for each exercise allow me to do the ones that work for me in a correct manner. They have benefitted me greatly. I started getting severe (8- 9 level pain in lower back and upper buttocks a year ago. 6 months later, I had RF ablation on facet joints at S-1, L5, and L4 on both sides. Immediate relief. Since then, back to excercises that equalize strength in my glutes, abs, and back. I now experience hamstring tightness but manage it pretty well. In fact, hamstring tightness and cramping were my original issue. Since surgery my hams are much less painful. The lower back pain (above and below beltline) is gone. I will get the same RF treatment again in 6 months. Love your channel, but the Title here may scare some away who need targeted ablation. Thank you, David- ps. My glutes, abs, and back were strengthened over two years prior to surgery and then subsequent ablation a year later.

[@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.

[@applenyc5300]

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

[@epmanualphysicaltherapy]

Sorry to hear this Apple NYC :-(

[@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.

[@81C3Vette]

I am now 61 years old and have been in the Military for 40 years. I am about to have the 4th RFA 04Sep24 and It is the only thing that gives me any relief from the debilitating pain in my lower back. L3/4 L4/5 and L5/S1 are fried and with a minimal amount of discomfort post op the pain goes away for approx 10 months before the nerve starts to regrow. Cortisone injections made no difference at all. Do not discount this treatment to allow you to rehab your back when you can't strengthen your back due to the pain you are in.

[@shanlowry-luther1244]

Sounds like you have a similar pain like me. I've done the cortisone, pt. Today, I have medial branch blocks, and hopefully, ablation after. Glad to hear you're getting relief . Thank you for your service. I don't take this country for granted, ever. People say a lot of things but take the United States for granted. Nonetheless, your comment gives me hope. My pain is located near the same area as yours. Good luck in the future!

[@shanlowry-luther1244]

It truly infuriates me that veterans don't receive all the support and benefits they need. I can't think of anyone more deserving than the military. Take care

[@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

[@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.

[@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.

[@vcash1112]

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

[@SharonPryor-hg9oj]

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

[@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

[@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.

[@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.

[@valeriebelmonte9556]

What if you have arthritis? Is your method of treatment the same?

[@epmanualphysicaltherapy]

Hey Valerie, great question! Here are all our videos about back arthritis. You can see there what kind of treatment method we recommend: “Back Arthritis Help” kzbin.info/aero/PLJVIPiFvv1maO8mjLabmoW2hgcx1XG2jH

[@valeriebelmonte9556]

@@epmanualphysicaltherapy thank you!!

[@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.

[@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.

[@FreedomLee721]

How do you feel about Intracept?

[@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.

[@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 .

[@Bella_bellz1111]

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

[@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!🙌

[@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

[@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.

[@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..

[@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

[@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.

[@Liavh_]

What happens if u don’t have pain but do the surgery?

[@epmanualphysicaltherapy]

Hi Alitalia, It's encouraging to hear that you are not suffering from any pain! 🧡That lets us know that surgery wouldn't be necessary. However, we want to reiterate that Dr. David specializes in helping people avoid unnecessary injections and surgeries using manual physical therapy which is very different from traditional physical therapy.

[@Liavh_]

@@epmanualphysicaltherapy hi yes I know but just wondering if I don’t have pain but my mri shows a herniated disk bulge and I go through with it will anything hapoen? Will any nerves be damaged that can deteriorate my health ? If they take away that nerve will anything negative happen in other words ? And what are the risks with this procedure is it safe? What are the side effects thanks in advance

[@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!

[@tracykeelan8534]

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

[@mrstee7004]

How do you feel about LMBB injections?

[@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

[@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?

[@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…

[@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

[@seanlin97]

Can you have one done after a failed posterior fusion?

[@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?

[@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

[@Drarpitmonga]

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

[@BuckeyeOne93]

I couldn't agree more. My orthopedic doctor referred me to a pain management doctor for the RFA. I declined. Good thing I did ! Just a thought... what would happen if your body is trying to tell your brain something really bad is wrong but can't because those nerves are burned off?

[@kelliec32]

I wondered the same thing... if I really hurt my back will I know?!

[@collegeri]

Doesn’t burning a nerve irritate the nerve?

[@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!

[@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?

[@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

[@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?

[@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?

[@johnslugger]

*I developed nephropathy in my feet and calves after my second Ablation for lower back pain. It sucks not being able to feel my feet and lower legs.*

[@Kristyrp]

I can’t do an exercise program after my epidural because I cannot walk more than 15 seconds with out terrible sciatica. I stay in bed all day. I am getting an ablation in a few weeks. It’s either that or surgery.

[@oppothumbs1]

RFA has improved but in such pain, you should think strongly about surgery though try Ablation first. I am not a dr. I have good insurance so that is easy for me to say.. Good luck.

[@morganschiller2288]

If your already bedridden get the surgery. What an RFA isn’t going to help is the spondyolothesis which can happen. Many of my patients have been either bedridden or carried in to preop. Some of the cases have been sad. People wait way too long to get it done. The only regret they have is why they didn’t get it done sooner. The first three weeks suck then you start to fee better. Its not fun to watch or have done but there is nothing that compares to the nerve getting decompressed

[@leahholmes3655]

will it help for sciatica or fibromyalgia?

[@morganschiller2288]

You have sciatica because L3/S1 is herniated. The disc is getting pushed into the dorsal rami of your nerve root causing immense pain. To make it worse your losing disc height as well which further compresses your nerves. Your lumbar plexus has nerves from L3/S1 all these innervate your leg muscles making it horribly painful. You need to find out via mri what is herniated and get it fixed. Find a surgeon who will fix all of the problems at once. Not fix L5/S1 only just because its fast money. I had bilateral RFA’s at L4/L5 it didn’t work, but the fusion did.

[@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

[@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!!!

[@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!

[@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.

[@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

[@AnnetteS-t6e]

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

[@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?

[@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.

[@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.

[@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?

[@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.

[@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.

[@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?

[@bethnesbitt3481]

I am 41 with chronic disc disease, bulging of the discs and arthritis in the lower back. I am supposed to get two different injections in the spine and then this. The doctors have removed my pain meds and said I have to get this done.

[@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

[@judysiek1452]

I've had 2 thr and 2tkr and I am only 61. My arthritis in my spine is pretty severe and I am very active and love to exercise. I don't want spinal surgery and have put it off for 10 years.

[@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.

[@Kameron232]

You are right! radiofrequency ablation (RFA) can potentially cause nerve damage. There is a small chance that the procedure may damage surrounding nerves and blood vessels, leading to symptoms like pain, tingling, numbness, or hyperesthesia.

[@y.g.1313]

This is life-saving video thank you. We are sitting at RFA clinic right now, will opt to go for physiotherapy.

[@catgranny]

So for the nerve block test, a patient isn’t completely sedated? It sounds painful. I’m going to have physical therapy first, but if not helped, RFA will be my next option. I have spondylolythesis L4/L5 and arthritis. I had an epidural cortisone injection for a herniated disc which relieved the pain, but I didn’t have sedation so I felt it. It hurt! I’m dreading the idea of the pain.

[@DrHenryDimaano]

L4-L5 degenerative spondylolisthesis which presents as back pain isn't something that RFA will relieve. You'd need a fusion procedure for your L4-L5 segment to relieve the mechanical instability pain. Luckily, fusion procedures can now be done percutaneously / endoscopically (i.e., the least invasive manner you could ever hope to do it, given the technology that's presently available).

[@sunbeamfactory5171]

You're not sedated. It's uncomfortable, but not extremely painful. They give you a local anesthetic, and it's a quick procedure.

[@morganschiller2288]

RFA’s are no more painful than an ESI. If your spine is that ravaged by arthritis, just get it fused.

[@johnhoward1313]

@@morganschiller2288: Easier said than done. A fusion isn't a walk in the park!

[@JermaineJohnson-d5w]

Hey,my name is Jermaine.from LA I got in to a commercial truck accident.i had a m,r,I done went to therapy did painmanent had 2 spain injection .2 block in in injection now go burn nerve 2 .do I have a good case

[@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

[@vonshawn9321]

Wow I had several injections done no relief had this procedure done nothing at all

[@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

[@maryjordan996]

Had RFA done couple months ago, was not worth the pain of going through. Will not have RFA again.

[@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?

[@TheBellissima1]

Disc spinal stenosis and spondylothestesis L3 over L4 Have had one cortisone injection and some PT And pain came back They want to do another injection in about one month but I just found you and want you to continue watching your video I will start your exercises for spinal stenosis that’s online I can use these exercises if I also have spondylthesis I understand that I need to strengthen my abdominal alignment and will work on this thank you

[@darlenepedregon4778]

Just had RFA procedure after trying all other common (and insurance required) pain management/reduction methods. My doctor was very clear - RFA very well may not completely erase all of my pain, but should reduce it enough so that I can get better sleep, have a higher quality of life, and feel well enough to exercise and strengthen back muscles (it was also made clear that pain relief is not immediate - it can actually increase for up to 4 weeks before the nerve acually stops sending pain signals, so a little patience is required.) It is so so common that people who qualify for RFA procedure are at a point where it is simply too painful to do physical therapy. I am hopeful that RFA will get me to that point. People with chronic, debilitating pain must look at ALL options, research them, and then make the decision based on their individual needs. I find it simply ignorant and wrong to title something so eye-catching as "NEVER GET RFA" and then contradict your own title by giving 3 separate reasons for actually considering the procedure. I hope that people looking on KZbin for advice on RFA will not stop after seeing this video, but will also look at the many, many videos that explain the procedure and reaults in much better detail and take the time to read comments.

[@cherylannesedler6788]

I am having it done this Tuesday to 3 on my right then the 3 on the left, PLEASE tell me they give you Propofol anesthesia, I read they don't but my pain management doc does for all my other procedure like, epidural, S.I. injections, facets, so wouldn't it stand to reason he would for this ??????? Please help

[@morganschiller2288]

No PM in their right mind is going to give you propofol for an RFA. There is no reason to need it. Once its numb thats it.

[@michaeldaggitt2635]

Hi Doctor David, I so, so wish that I'd seen your video on 'Why You Should Never Get A Radiofrequency Ablation For Chronic Back Pain' before I was advised to have the procedure by a UK pain doctor. I had my RFA last year (June 2023), as recommended by the pain doctor, due to severely degenerated lower spine facet joints at L3/4, L4/L5 and L5/S1. Since then my severe 24/7 lower back pain has become much, MUCH worse. I sleep very, VERY little when compared to before having the RFA, and I now hardly ever leave the house, even short car journeys are excruciatingly painful. I would like to ask your good self, hearing what you stated on the lack of evidence on nerve regeneration, is it possible the 'burn't back' nerves have grown back in a more widespread fashion ie. like the branches of a tree causing my pain to go from 6/10 - 7/10 to a constant 9/10 on the pain scale? I have to wonder if this is the case because before my RFA I was at least able to ease my pain a little by laying on the bed but I now can't even do that due to the severe pain and discomfort. At bedtime I have a BREG. VPULSE cool pad to lay on which gives me a little relief and distraction before my sleeping tablet takes effect to give me, at best, up to 2hrs sleep. I use freezer cool gel packs when I sit, which I do during the day. I am thinking that my life isn't worth living any longer due to this constant hell I am going through. It so breaks my heart as I so, so love my wife and family, and to see them in anguish due to witnessing me being crippled with pain is just so hard to take. Thank you again Doctor David and for reading my lived experience. The Kindest of Regards, Mike from the UK (66yrs old).

[@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 🙏🏻.

[@bearsmartdurango]

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

[@Shannon-w2j]

Anyone have blue cross and had this done ? My insurance is saying they will not pay for this ..

[@rimamcfarlane2202]

You are right about trying different PT, they don't always know what's best. After 13+ years of horrible pain I found one that ACTUALLY LISTENED to me. He actually LOOKED at my back and felt my spine etc. He has actually taught me why I have some of the pain I've been in for so long, I have all kind of chronic pain partly because doctors NEVER BELIEVED THAT I was in so much pain, So NONE of then did anything but send me to PT. Pt only made my pain worse as well as what was causing the pain.

[@epmanualphysicaltherapy]

Hi Rimamcfarlane, Thank you for reaching out to us! 🙌We are so sorry to hear that you have been suffering from such long-term pain and that your experiences with different PTs have been frustrating and unhelpful.🥺 It’s awful not to be heard, especially when it comes to your health and well-being. We’re glad to hear that you finally found a PT who actually listened to you and took the time to look at your back and understand your pain. It’s so important to have a healthcare professional who truly listens and acknowledges what you’re going through. You know your body better than anyone else, and it’s great that you trusted yourself and kept looking for the right help. We hope that with the help of your current PT, you are now on your way to recovery and gaining a better understanding of your pain. We wish you all the best! We'd love to hear how you are doing as you progress.🙌 Please take care!

[@judysiek1452]

I just had one today. I haven't had one in many years. I am in more pain now then I was this morning.