Denervation...advice

[susancook]

I have a 36 degree thoracic lumbar scoliois s curve and my pain management MD suggested 2 medial branch blocks with lidocaine and then if I had 80% or more relief of pain from that, then he could do a denervation. Anyone had experienve w/ this? My pain is mostly a buring R sided pain and pain over the spine. I am in an "8-9" pain in the evening, most evenings. Any help in assisting me to understnad this would be helpful Thanks.

[rohrer01]

First of all, WELCOME!

I am a fellow pain sufferer with relatively small curves also. I have not had denervation, which I'm guessing is the same as nerve ablation? What levels are you having pain and where specifically is your pain?

[jrnyc]

i have had nerve ablation...didn't do much for my severe lumbar pain, though...
but that is not to say it wouldn't help you....
the nerves grow back anyway....

jess

[susancook]

First of all, WELCOME!

I am a fellow pain sufferer with relatively small curves also. I have not had denervation, which I'm guessing is the same as nerve ablation? What levels are you having pain and where specifically is your pain?

Everyone on this forum is so good at knowing exactly what level everything is....my pain is in the right side, the concave side of the curse about my bra level. Guess I should get an anatomy book and figure it out. According to my xray, I have "severe degenerative disc disease" from T10 to L5 and "moderate disease" from L5 to S1.

[susancook]

i have had nerve ablation...didn't do much for my severe lumbar pain, though...
but that is not to say it wouldn't help you....
the nerves grow back anyway....

jess

Thanks for your response. I do understand that it is a temporary fix....if at all, but I would love some pain relief, even temporarily!

[Pooka1]

According to my xray, I have "severe degenerative disc disease" from T10 to L5 and "moderate disease" from L5 to S1.

DDD is said to be like death and taxes... inevitable if you live long enough. The vast majority of adults end up in a doctor's office for back pain at some point in their life, maybe mostly due to this.

The question is if you have more advanced DDD for your age due to scoliosis. And then the question is what treatments will help. Only a surgeon would know.

My father-in-law has debilitating pain issues which I assume are DDD but he is 72. He has no scoliosis.

Good luck.

[susancook]

First of all, WELCOME!

I am a fellow pain sufferer with relatively small curves also. I have not had denervation, which I'm guessing is the same as nerve ablation? What levels are you having pain and where specifically is your pain?

Thanks! My pain is in the thoracic area mostly on the R side. I have pain over my spine and lateral to the spine. It is generally a burning kind of pain. I also have sciatic pain on the Right side.

[rohrer01]

Treatment for the DDD may solve your pain problems. Did you have the scoliosis or the DDD first? I know that many people w/out scoliosis develop DDD, But I also wonder if those with scoliosis develop it faster. My DDD was "mild" as of two years ago, yet still caused a significant amount of sciatic and back pain. I also have suspected sponlylolysis. I haven't had the proper test to confirm it, as there's not much that can be done about it anyway. I have no vertebral shifting on x-ray. But DDD along with arthritis can be very painful, even in the mild stages. So it's not surprising to me that you are in so much pain. I hope your procedures work. My last epidural steroid injection worked for about a year before symptoms started coming back. It's definitely worth a shot (no pun intended!).

[susancook]

Treatment for the DDD may solve your pain problems. Did you have the scoliosis or the DDD first? I know that many people w/out scoliosis develop DDD, But I also wonder if those with scoliosis develop it faster. My DDD was "mild" as of two years ago, yet still caused a significant amount of sciatic and back pain. I also have suspected sponlylolysis. I haven't had the proper test to confirm it, as there's not much that can be done about it anyway. I have no vertebral shifting on x-ray. But DDD along with arthritis can be very painful, even in the mild stages. So it's not surprising to me that you are in so much pain. I hope your procedures work. My last epidural steroid injection worked for about a year before symptoms started coming back. It's definitely worth a shot (no pun intended!).

Thanks for you vote of confidence. I see the pain managment MD this week, so I'll set it up. Apparently I have to have 2 blocks that are successful before they do a "Radiofrequency Neurotomy". So hard to figure out what causes the pain? Scoliosis, DDD, arthritis,....If the Neurotomy solved my problem, that would be awesome and so much easier than scoliosis surgery, huh? Then I guess that I just "follow the curve" and have xrays done to check the progression of the curve. I'm going to ask the scoliosis surgeon whate he does for the DDD in the surgery when I see him this week, a busy week! I have "severe" DDD from T10- L5 and "moderate" DDD from L5 to S1. Can't help the situation much, huh?.
Susan

[jrnyc]

a friend in CA had arthroscopic surgery for DDD...he is fine now, though he does not have scoli....
it was nothing compared to fusion surgery, per his report...

most pain management treatments are a world away from scoli surgery...
most are simple in comparison, easily done in a doctor's office...
get up and walk away afterwards....then hope whatever it was... worked....
people have reported all kinds of results after such treatments, from no relief, short term relief,
to longer term relief....
most report no complications, which is nice for any tx....

jess

[susancook]

a friend in CA had arthroscopic surgery for DDD...he is fine now, though he does not have scoli....
it was nothing compared to fusion surgery, per his report...

most pain management treatments are a world away from scoli surgery...
most are simple in comparison, easily done in a doctor's office...
get up and walk away afterwards....then hope whatever it was... worked....
people have reported all kinds of results after such treatments, from no relief, short term relief,
to longer term relief....
most report no complications, which is nice for any tx....

jess

Thanks for your response. It is hard to sort out just what is causing my pain? the scoliosis? DDD? arthritis? other fracturing of little old lady back? anyway, the discs can't be helping any and that is a question that I have for Dr. Hart is for him to estimate what is causing my pain of all of the possible etiologies. Then, if I do [and that is a big, big distant] have the scoliosis surgery, what will he do for the discs? I will ask him about "quick office fixes" for discs that he might be able to do, but when I have asked him about minimal surgery in the past, he has assured me that it was not appropriate for my back. I'll see what he says.

[jrnyc]

i do not believe there are any "quick office fixes" for bad discs...
or for any spinal pain or injuries for that matter....

when discs are first injured, many doctors give high dose prednisone, then wean
the pills down...i found that doesn't help much...it helps with the pain initially, but then
you have to go off the prednisone, and the disc pain is back...
any in office pain treatment is temporary, addresses the pain, doesn't fix the discs themselves....
my CA friend who had arthroscopic disc surgery had 6 weeks of recovery, after which
he was fine....but as i mentioned, he does not have scoli...

bad discs can cause really awful pain, and the pain can go on for a long time...
i have also found that disc injury can reactivate with any new stress on spine...
my husband has a good back, but he hurt his discs, and his back hurts all over again any time
he does anything stressful to his spine...

in office treatments are fast compared to scoli surgery....compared to any major surgery....
but they are not able to fix the problem itself...the steroids address the pain coming from the problem...
and steroids carry their own risks, as i discovered with my cortisol problem....

for many years, the theory was that "scoliosis doesn't hurt"...doesn't cause pain...
that theory is STILL subscribed to by many doctors...


jess

[rohrer01]

Susan,
It's also my understanding that they treat adult onset degenerative scoliosis much differently than those of us with unknown etiology (IS - idiopathic scoliosis). I don't think the trigger in degrees for surgery is the same. They want our curvatures to be much higher. So I don't know what the criteria are for fusing with progressive degenerative scoliosis. You'll have to ask your doctor about that one. I hope you can get some pain relief in the meantime.

Rohrer01

[susancook]

Susan,
It's also my understanding that they treat adult onset degenerative scoliosis much differently than those of us with unknown etiology (IS - idiopathic scoliosis). I don't think the trigger in degrees for surgery is the same. They want our curvatures to be much higher. So I don't know what the criteria are for fusing with progressive degenerative scoliosis. You'll have to ask your doctor about that one. I hope you can get some pain relief in the meantime.

Rohrer01

Thanks for your response. You are right that the curve numbers are not necessarily what triggers surgery. Dr. Hart said criteria for me would be: pain, increasing curve [think he said 5* in one year], compromise of GI or lungs, loss of function, but mostly pain. I'll let everyone know about the diagnostic medial branch blocks and then the Radiofrequency neurotomy. These procedures are supposed to deaden the nerves that supply the facet joints. The denervation has the advantage of treating pain and avoiding or delaying surgery. The treatment only lasts from a couple of weeks to maybe year or a little more, but any kind of relief would be welcomed. I'm looking for new ways to deal with pain. I'm not in enough pain to consider fusion surgery, but am pretty miserable, especially in the evening. Analgesics don't seem to work and I think that the PT has helped as much as it is going to help....bummer. But, I will continue to do my exercises. The stretching of my back feels good and does break the monotony of the pain.
Susan

[titaniumed]

Hi Susan

I just wanted to say welcome...

I went as long as I could and had pretty bad lumbar DDD and 4 herniations with sciatica. This can also lead to end plate damage....a good question for Dr Hart.

I did not do any shots. It was offered....but at the end with my x-rays looking pretty bad it just didn’t make sense to me. I was barely walking and pain was spiking 10. Death and taxes, and my tax was due. I was a Luque wire candidate in 1976 so it was a long wait.

I did just about everything else, Chiro, massage, and hot water soaks. Hot water is the easiest way to get the most relief from extreme pain events.

I do have a stretching machine......and an arch table. Electrostim machine, sock installer, walker, ski poles, and scuba gear! All used for scoliosis.....Just PM me if you are interested. The stretching machine is a professional unit that was ordered by a doctor for me, and its heavy duty and weighs a few hundred pounds...not an easy thing to move, but can be done. Anything is possible, I’ve proven that.

Ed