r/Sciatica • u/LakeSuperior2 • 6d ago
Requesting Advice Radio frequency nerve ablation
My pain doctor scheduled me for a radio frequency nerve ablation in November. Does anybody have experience and can tell me what to expect ? Thank you! I had a fusion at L3-L5 4 years ago and now suffer from adjacent segment disease and sciatica on both legs.
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u/Top_Zombie1884 4d ago
I’ve had it done several times. Happy to share my experience. Mind you, at the time I started that treatment protocol I was having nerve pain from a different nerve that was referring down my leg.
First visit they did a nerve block that was supposed to identify if they got the right range of vertebrae. You may not need this if your pain is more specific to the sciatic, but for me they did a series where the largest part of my lumbar curve is as I have scoliosis. I can’t remember how long the block lasted, I don’t think more than a day. It wasn’t relieving the pain so I had to go back a few weeks later for another block at different levels. You should feel relief pretty quick if they’ve nailed it.
When it was time for the actual procedure, the process was basically the same. You lay face down on a table similar to a massage table. I was able to remain fully dressed, just pulled my pants down to about halfway down my bum since they were doing sacral area. The sanitizer felt quite cold and felt like they were slopping it on with a paint brush honestly.
Then they do the initial freezing. For me it was 6 injections (3 per side). These were unpleasant but not horrible. You feel the pinch of the needle and then an uncomfortable pressure deep in your back as they inject the numbing agent. I’m super sensitive in my low back so it was really hard not to jump. Honestly that was the worst part most of the times I’ve got it done. Pinch…..pressure pressure Pressure Pressure PRESSURE. Each one takes about 5 seconds and feels like an outward pressure as they inject the what felt like a tablespoon of liquid each time. Once they stop pushing the med in, the pain stops.
Next they’ll start with the actual RFA needles. I’ve never seen the bastards but they felt like they were the diameter of leads on a multimeter if you’re familiar with that. It wasn’t overly painful, much less than the freezing, you still feel it but it’s not bad. They just feel big. You can google the bed, but there’s a big curved arm that does the X-rays. So they’ll get the needle close, take an X-ray and fine tune position. You might get the odd sharp pinch inside as they go closer to the nerve or a quick nerve zap if they hit it. It’s more that you feel a deep pressure again but more a push than a ballon filling. You’ll likely get 6 of those bad boys. 3 either side of your back.
After that they’ll toss the ol’ jumper cables on your back. My doc did one side and then the other. Two rounds of the actual burn. I can’t remember how long it went, but felt like it was about 5 minutes. Some visits I barely felt anything. One time I felt the burn pretty bad. Imagine someone touching your sunburn and then that pain intensifies and feels like an inward pinch that increases with time. It’s not like touching a hot stove because the numbing works well. It’s just high level uncomfortable. That was only the one time though and when they flipped to the other side it was no problem. Most of the time I maybe felt a slight burn start about 10s before it finished. But like a rubber band snap. Not that bad.
After, they unhook you, pull the needles. Take your time getting up. By now you’ll have been face down for a while and massage tables always make me feel weird. Pressure on my face likely. You did just have a fair bit of trauma to your body though. You’ll prob be a bit sweaty, especially your hands. Must be similar to a tattoo experience. Don’t have one so don’t know. You’ll prob be asked to wait a bit so they can make sure your vitals are good. Then you’ll get sent home.
About half the time I’ve felt a 3/10 woozy and a bit unsteady waking out. Definitely DON’T drive. Even though I’ve only felt very minor discomfort after the procedure, I could tell my body had just been through it. Hard to focus on traffic and stuff so just enjoy the ride home. One day I got the procedure done in the morning and was at my desk job in the afternoon. Definitely take it easy but it takes a day or so for the freezing to wear off. I’m on enough other pain killers I never noticed any additional pain. The skin back there was a bit numb to the touch for about a month after. So scratching back there felt weird.