Best explanation I have seen on facet issues and ablations. Thank you for taking the time to put this together. I would have you do an ablation on me in a heartbeat 👍
I’m having the first of these procedures on Tuesday and I am so grateful for the exquisite explanation as I was very apprehensive until I watched it. Thank you for this informative series!
I just completed my second MBB. I walked out of recovery room and walked 1.25 miles with no pain. Waiting for PA for ablation. I plan on walking and doing crunches everyday to lose the weight I put on secondary to pain and strengthen my core. It is nice to hear the same steps of the procedure and expected outcome from you that confirms what my physician has explained to me. I am looking forward to being pain free after 1.5 years post laminectomy.
Just got a new MRI. First since 2018. Looks like I will be learning all about your topic. I have mild to moderate facet joint osteoarthritis on L1 through L5. Protruding discs. Neuroforaminal protrusion. Ligamentum flavum hypertrophy. Neuroforaminal narrowing. I’m 65 and have worked and played hard all my life. I guess I’ve got to pay the fiddler. Great info and presentation. Thank you.
I really appreciate these videos IM 62 male ive had L5S1 and my neck fused 7 years ago now im going thru this. Almost 1.5 years of hell Luckily im in pain management now and can some relief with minimal opioids during the day.I do believe my body is very slowly healing itself cause recently the pain seems to be moving up from my lower extremities to the lower back area part of the day anyway and recently ive been able to take longer walks without having to stop and sit down 😁
Thank you so much for that detailed explanation of the syndrome and the treatment. I watched so many videos related to this topic, but your video connected all the pieces of the information together in my head. Thank you for that
Your presentation is amazing! My wife has lumbar stenosis and degenerative disc disease. She’s in great pain and barely walks. I now understand how important it is for her to become more mobile for her health. We live in Michigan near Ann Arbor. I would have thought neurosurgeons here would have the same information you have, but her surgeon and pain management doc have never discussed any of the ideas you have presented. Is there any neurosurgeon in our area who is as knowledgeable and experienced as you?
51 yrs old. I don't know what to do first. I can't even stand up straight. My muscles stay sore 24/7 and this going on for abt 3 or more years now. 09 full tear in left knee acl and va said at my age they opt not do surgery, left me like that, 2013 hurt my back real bad heard a pop resulted in Spondylothesis in lumbar and facet hypertrophy and spinal stenosis severe exit foraminal stenosis and one fully collapsed hip and other hip partially collapsed hip. I keep getting told no one does backs. The va hip surgeon said let's settle down the back and do full back work up first and va just sent me to another hip surgeon who doesn't do backs. And back in 2016 va sent me to a neurosurgeon and he recommended trigger point injections and I still haven't gotten them either. Thank you DAV for giving me the zinger so I have a way to walk my dogs. This all started with Cervical injury in 2000. I have no pain in Neck th9ugh thank you Lord literally. I don't even know where to start to even help myself. The va is so bad. I can't take the pain anymore. Otherwise I'm healthy. Does that sound crazy or what. Somebody Please help.
Wow wow wow - how educational. Had an MRI yesterday, found out about my facet problem. This is so informative! My ex died years ago after a neck operation so of course I’ve been nervous of course. But I am in much better shape than him so will actively work on PT.
Thank You so Much. You are the Only Person that explains this Process Thoroughly. I Now have a better Understanding of what is going on. I wish YOU could Fix me Up. As The Word Says: You shall hear the Truth and shall Know it
I have had nerve block done, it confirmed median nerve at Facet joint but I am having hard time making decision on ablation. Great explanation, well done!
58 y/o male here. had my first ablation 5 months ago and the pan is back to square 1. I have messaged my pain Dr today with your information. I hope he comes back with more than "well lets try it again and see what happens" Terrible painful process for only a few months of semi relief. Maybe 50% better for a fraction of that. Thank you!!
Thanks for the "Education" it was brilliant, been suffering with lower back pain for a few years which has been diagnosed as multiple things with multiple solutions (none of which resolved the pain), recently I had a radioactive bone scan which highlighted the arthritis in the facet joints. In 2 weeks I go in for an RF Ablation, fingers crossed it provides some relief and after watching your video I am much more confident :)
Your presentation on this subject is excellent. Thank you for taking the time to make these videos. They are really helpful. I suffer from low back pain and in 2020 the Orthopedist said it was my Facet Joints. I had a steroid injection which helped but the pain came back. Then the orthopedist said I had SI joint disfunction. The next injection did not address my pain. Fast forward to 2023, with daily stretching and PT i am much better but still suffer with muscle pain. I will be seeing a new Pain management Dr. who performs the oblation and rhizotomy. I'm ready for anything that will help.
I have had the first sets of needles. The first two did not last very long at all. The ablation was the same. I t has been six months and I will being seeing my doctor next week and back pain is back to where it was in the beginning. The pain begins at my lower waist to my lower back just above my tail bone. I hope he will try the next procedure, I really need relief. Thank-you for educating me. I live in Northern Maine very close to the Canadian boarder. Wonderful info!!
I'm 69 and going to have a bilateral medial branch ablation at L4, L5, S1 on 6/18/24. The two diagnostic blocks gave me 80 to 90 percent relief. I'm looking forward to real back, buttock, and hamstring pain relief. If i have to have facet joints screwed for fusing, I'm hoping it's a few years out. I'll comment on my progress around 7/10/24. - Joe Frisina in PA
I'm 19 days post bi lateral medial branch ablations at L4,5, and S1. I feel that my relief is around 90% or better. Just some superficial sensations in my lower back and upper buttocks. My legs feel lighter, and it is easier to walk my 2 miles every other day. In between walking, my workouts at home are easier, too. I'm glad I had this done. - Joe Frisina
@@user-fq1xh7bg7gJoe_FrisinaPlease keep on informing. Your information about how long the relief lasts will be very helpful to many of us. My opinion: if it took the pain away, still be careful with workouts. Do them slowly, because the nerves swell with vigorous repeated movements. The nerves can swell and are compromised, although you don‘t notice it.
Thank you very much, Sir. Your video should be shown to all medicine students to each them how patient‘s information should be done. First of all, we need to be addressed as adults who can ask questions when there is something we cannot understand. Second, facts are less scary when explained with an empathic voice and good eye contact. Third, the best way to create a positive outcome of any procedure is by creating a safe environment.
Tysvm for making this video. U hav helped me sooooooo much thru this video & friends. I am so very sorry about your mom. I loved this video & God bless you 4 taking the time to do this 🙏🙏🙏
I had the first round cortisone and steroid injection done this way 2 weeks ago , I could feel the difference within 30 minutes. Booked for another injection in 3 days, my neurosurgeon said it should keep me pain free for up to 18months. Fingers crossed. I have also started physiotherapy to strengthen back muscles.
Having an ablation done next week. Once it is done can I attempt to not be a lazy American and do PT exercises that may help it last longer or even eliminate the issues?
Thanks so much for this great explanation! I am in the UK but am having the MBB and then hopefully RFA in the next couple of months. Literally can't wait as I can no longer sit comfortably in my recliner in the evenings. Your video has inspired me to beg them to stick a bit of steroid in with the MBB 😂
What a brilliant video! Two years agoI had a spinal fusion of L5-S1. And somehow the surgeon when he was inserting the pedicle screws into my spine, accidentally put one into my facet joint. I’ve been in so much pain since the surgery. Tomorrow I’m going to the hospital to have a CT guided steroid injection to the area around that damaged facet joint. Hopefully, it brings some relief. I do feel a lot more positive now after watching your video. I thank you for that
Thank you! I see my Dr next week Re ablation consultation. I believe I will be a better informed patient. The best part is it may lead to a longer life because I can be more active physically. (I was an active runner; today a quarter mile walk and I’m gassed.)
I just had my first Medial Branch Block on April 10th and I got great relief, I had to grade my pain when I got home, doing household chores, and grade my pain each hour ,for 7 hours, then give a percentage of total relief. So right after getting off the procedure table, I had NO PAIN, then when I got home, I stood at my kitchen sink and did dishes, which normally couldn't stand no longer than 2 mins and the pain would show up, then I would have to sit down, so I did the dishes this time , was standing there for about 8 to 15 mins, had zero pain. Then did some vacuuming, had no pain, standing while dusting, so was only giving a grade of 1/2 on the 3,4, and 5th hour, then on the 6th hour I grade my pain a 1, and the 7th and last hour I graded a 2, which before my procedure I graded my pain an 8 ! And so I gave the total percentage of relief I got from having this procedure, I gave it 90% relief that I received!! So my pain doctor has me scheduled for June 3rd to have my second Medial Branch Block! I can't wait!! It was not bad at all! Just felt a little sting for about 3 seconds each time they were getting ready to numb me. So I didn't jerk, move or make any sounds. So hopefully after this 2nd Medial Branch Block, he will want to do the Radio Frequency Block. Your video I enjoyed so much, it explained so much that has went on with my Lumbar Stenosis and what to look forward to going forward. I am a 67 yr young woman.. Keep up the good work Doc!! Sharon Carroll from Archdale, NC 🙂
Thank you for sharing I'm so glad to hear your review ,I have an appointment for MBB on May 2 coming up you and the Dr give me some strength to do it thank you very much 🙏
Very informative, thank you! I had the 2 diagnostic procedures done and had my first ablation 2 days ago (9/25/24) I could feel the burning of the nerves “slightly” was very numb but could tell it was happening. The first day, I was sore, aching and had a slight, deep throbbing but moved gingerly throughout the day. I could only stand for short periods of time as my lower back would get heavy and begin to ache. The following morning I was a little sore but as the day went on the soreness was lessening, I was amazed! I’ve had so many epidurals and facet blockers for so many years and was excited for this but also a little skeptical. It’s been 2/3 days and I can barely tell I’ve had it done and have only experienced very mild pain compared to what I’m used to! Bottom line, I do believe this has and will continue to help quite drastically! For how long is yet to be seen and felt 🤦♀️ Excited to finally feel free of pain and hope this continues for a long time! Good luck to everyone, if anything changes I’ll try to update. Thank you doctor for such a thorough explanation and helping to change so many peoples lives ❤️
Outstanding video. I have been watching several of your videos. You have taught me so much and helped me be more comfortable with the science behind pain management. I am suffering from low back pain and through yoga I have developed sciatic nerve pain. I will be calling your office to set up a consultation. I live in Jacksonville but want to have “good hands” working on my back. What are your thoughts about the ultrasonic bone scalpel? A video on that technology would be appreciated. Thank you for the education.
@@joanverbarg2529I had the MILD done on me Dec 30th, 2022, I have Lumbar Stenosis LR 4 and L5. It didn't help me at all. Only relief I am getting is sitting down when I am up and the pain flares up, I have to sit down to get the pain to stop. I am thankful for my pain management doctor, we had had to go through all the steps since he did the MILD procedure, just to get where I am today, because like this doctor says, the insurance companies have a "protocol " you have to go through, try other things before you have the major one that WILL help your pain. So I am scheduled for May 29th to have my 2nd Medial Branch Block, the first one he did April 10th and it helped me TREMENDOUSLY! So I am looking forward to May 29th for my 2nd one and then hopefully the next step after that will be the Radio Frequency Block 🙂
Excellent video. Thank you for explanation of facet joints and the different options to help alleviate pain. I’m 45, Canadian and I was in a car accident in November 2014. I was rear ended by a distracted driver. Before the accident I was very active. I loved to dance. Now, I have L5-S1 LEVEL: There is severe disc space narrowing with diffuse disc bulge and endplate osteophyte formation. There is also severe right-sided facet arthritis and mild left-sided facet arthritis. There is right- sided facet hypertrophy and ligamentum flavum hypertrophy. L3-L4 and L4-L5 levels are not as severe, but there is disc desiccation, arthritis and disc bulge. I have just done the steroid injection with success with pain free for 3 months. Now I’m waiting to do the ablation.
A very nuanced and thorough explanation. You have my thanks. I have intractable low back pain that prevents me from running, bending over without support, let alone lifting heavy and moving normally. I have DDD at L4-S1. I had a facet block last week that removed all of my pain for a day or two. I am going to get RF and see how long I get relief. This will be the second time around I get RF for facet pain, and if this time the relief does not last indefinitely then I will get surgery. I could get a fusion, but have been looking into disc replacement and I would prefer that option if it is suitable. I saw a surgeon that specializes in disc replacement and his perspective is that disc replacement will eliminate my facet pain because my facet pain, in his view, is due to poor dynamics as a result of significant disc height loss (more than 50%) at L5/S1. My facets are only mildly arthritic in imaging. I wonder if you think his point of view could be correct. Of course the safer route is fusion, but I would like to avoid that if I can.
What about if I already have A cage from L3-L5, and now I have have severe spinal stenosis in L2-L3 on center canal & on left & right facet joints. And mild to moderate facet arthrosis and a shallow disc bulge on L1-L2? Can I be a candidate for a endoscopic rhizotomy? Pain on L2-L3 runs down my left side to my arm, knee. And chin? I did physical therapy 6 weeks and got an epidural which lasted about 5 days & was given from 300-600 Gabapintin which does nothing but make me tired. The inside of left knee pain abated some but never really left. After four days it was all back. Although PT has helped a lot, the weak thighs and knee pain are still here. I continue to do all the same physical therapy exercises that were taught to me at PT at home. I even got a stationary glute bike, and still the inner sides on my knees can’t touch as the left knee throbs, cramps & locks up when I try to sleep on my side. I use to walk 5 miles a week now I am lucky if I do three. I went to an orthopedic surgeon Dr M Barnum he wants to remove my L3-L5 - cage & 8 screws, and replace them with 10 - screws 5 on each side screws. A laminectomy fusion with instrumentation. I’ve Had three spinal fusions. It’s physical trauma on a human being along with the mental trauma of losing my 21 yr old son. I am 65 yrs old, he spoke to me like it was a breeze, a walk in the park. I’d be out in 2-3 days , walking immediately yada, yada, yada, perhaps he missed the part where I told him I’ve been there, done that & it’s not a walk in the park. So I won’t be going to him ever again. He is at Advent Hospital here in Florida. I will now go see a neurosurgeon at Orlando Health Dr Virgillio Matheus on 11/21 to hear what he thinks my options are. Wish me luck! Thank you for explaining the process, the procedures, medical terminology and even the difference on the insurance financial aspects and making that clear I get it. I’ve been in the behavioral health medical field for 28 yrs and ran a center in NYU Langone so I know about some of the things you spoke about. I know you won’t be able to directly answer me, but I wanted to thank you for giving me the knowledge I needed to ask the right questions. On 11/21/23 Millie Crespo
Are you familiar with the new procedure INTRACEPT PROCEDURE and what are your thoughts. Is it permanent or does it need to be repeated over time? I have spinal stenosis and my doctor who retired recommended this procedure. He stated it was permanent once and done, however; in looking up this procedure I’ve heard otherwise.
I have osteoarthritis hip replacement at the age of 52. Ablations shots, Ive had it all. Now I’m having lower back pain. Just had an MRI showing spinal stenosis
I love following your journey and now I am your patient..💞🙏..I have been reading and following all of your extraordinary videos so thoroughly explained. I cannot wait until you attempt my back..I have 100% trust and faith in you and your knowledge and professionalism. I am enjoying learning everything about the spine, procedures and severity of it all..Thank you for all,of your passion and compassion for helping the quality of our lives…👱🏻♀️🤗💞🙏👍🥇🏩
Had 6 lumbar ablations last week to help with pain. Also have 17 degree scoliosis L2-3 from car accident years ago. One doc doesn't want to operate, another devised a fusion plan anchoring in my pelvis up to the 3rd from bottom rib to straighten everything and alleviate the lumbar lower thoracic pain.(Also have cervical stenosis that affects my arms/hands; neither doc wants to go there right now.) Will these "screws" work for combined scoliosis/stenosis? Thank you. 1/11/24
I get very bad groin, lower back thighs Buttox can’t walk far now spondylitis told to L4/5 S1 tried injections rubbish had leminectomey 50 years ago now had very bad fall that is how this is worse.😅😊 retired law enforcement old 71 worried now waiting for operation but just worried of uncome😮 excellent video
54 years old. severe Facet hypertrophy. L3 L4, (L4 L5 also with central annular tear), L5 S1 with broad based disc bulge, Degenerative disease/multilevel diffuse disc bulge. Moderate degeneration of T11 T12 , L1 L2, L2 L3. I am being scheduled to have these facet injections. One thing that I heard you mention that does not fit my issues is that sitting helps with no pain. I am not like that at all. If I stand I get pain after short time, if I walk on concrete with my work boots I get pain quickly or at a mall with my good runners on! If I push pelvis forward it hurts or looking upward. My only relief is laying down and keeping inflammation to minimum. If I sit for long I get same lower back pain as standing. I also have mild scoliosis happening. I have hurt my back countless times over my career, I move 700lb tanks by hand for over 10 years. I hope these injections help me! I want to have a decent retirement and not be a crippled old man, I worked too hard to have my golden years taken from me.
Explained well. Had epidurals yrs ago & didn't work after an injury. Just had 2 sets of shots with a fluroscope. Some relief possibly but supposed to get an ablasion if I decide to but not sure if it will help. Temporary from what I am told. L4L5 are gone & have bone spurs. 2 other discs are bulging. Stenosis & degenerative disc disease. Family trait. Don't want to end up like my dad. Helping a neighbor pull bushes, he felt something pop in his back. 2 surgeries & never walked again.
I had the vertiflex 5 weeks ago at L3-4 and L4-5. It helped the pain down my leg but I still have heaviness in my back and pain when sitting and standing. Oddly walking doesn’t bother me and never has. Before the vertiflex procedure my doctor gave me facet joint injections which worked so well but only lasted about 4 weeks. What would you advise? I live in Oklahoma City
Getting ready to do these procedures at UM in the next month or so. L5-S1 disk is gone. 1st step is the block, 2nd step block again then as you mention, ablation will be approved. Hoping it helps enough to avoid Fusion. Trying to avoid surgery at all costs. How many times can you have ablation’s?
I have facet joint arthritis with bone spurs plus stenosis in my lumbar spine. I am due to have this procedure. My question is will it work with stenosis? I am struggling to walk and stand which may be claudication, I also have cervical spine issues had acdf two levels last year but now c7 has moderate stenosis. My lumbar issues cause pain in my buttock pain down leg even my shin and ankle throb and get swollen at times, I’m confused best way forward for my treatment appreciate ideas you may have for me to discuss with my surgeon
I have been dealing with back pain for 20 years. I've had three MBB which lasted only a month. First time seeing a neurosurgeon and she has diagnosed my problem as facet joint arthritis, central canal is open. I also have a left "C" curve scoliosis in my lumbar spine complicating my facet joint instability. I'm hoping to get an appointment with a neurosurgeon specializing in deformity. I will certainly ask his opinion about the screw when/if I get that appointment. Thank you very much for this video.
@wportermcroberts The implanting of a titanium screw on the facet joint. Can a person lift heavy weights and do heavy labor work after recovering from that procedure. And if so how long g would that recovery period last?
Awesome video! One question: At 16:48 into the video, you describe that a steroid is often included with the numbing medication when performing a medial branch nerve block. That it is injected "right next to the arthritic joint" and that sometimes long term relief is achieved. Bit puzzled by that. I assume the inflammation is within the facet joint. How does the steroid reach the inflamed area. Is it adsorbed through the synovial sac? Going through this now...
I had lumbar fusion 2-5 four years ago. Have had many injections, RAF,spinal cord trial, Peripheral nerve stimulation, scramble therapy ,laser treatment all to no avail . Nothing has helped ! My lower back still hurts every single day. I do take tylenol and hydrocodone to ease my pain. According to my recent MRI I do have bilateral facet joint arthropathy .
Very well done. I am a 61 female, lost almost 2” from 6’1, to 5’11. Dx spinal stenosis and degenerative disk disease and facet joint moderate arthritis. Bilateral hip arthritis is moderate. Had years of steroid injection in L5, then a new Dr said the bigger issue is the facets. Had two injections 11 yrs ago and was gold for years. Now, with weight gain, I’m pretty sore 80% of time. Social worker who walks, but now limited to distance as pain increases. This was so helpful to me as with most, who have significant back issues, I feel at a limit with pain and get fearful of what’s next, will it be more painful. THANK you for this video. I see interventional pain Drs soon in Idaho (live in small rural town in Oregon) and now feel like I have had a pre primer for the visit. Jane
Hi Doctor thank you for your help. My son have one of those injection to block the pain after a synovial cyst in his L4. After a month he start to have itchy in his leg can be relative to the injection ?
Thanks a lot doctor for this information. I've been diagnosed with facet joint synovitis for a few years and i didnt really know all the options available and how long could it actually take to feel relieve with all of them. What if i put in the work on the gym? If i get stronger, build more muscle in my back and lower back and general build more muscle in my legs and body in general. Can this make it to the point of not being close to not need a fuse ever?
What would be the reason that a regular ablation is still considered above the endoscopic removal is the removal of the nerve is a longer relief up front? Insurance?
Hello doctor is facet joints is the same as spinal stenosis ? Also I have degenerative disc disease, I ve had so many problems in my lumbar and neck and I already had lumbar laminectomy surgery but pain its worst then before so what do you recommend to me? Thank you I love the way you explained everything step by step.
Thank you, Dr, this video was extremely helpful! 61 year old, marathon runner since 1980 and still going. I do regular core strengthening, including Superman. I rarely have back pain, but have developed glute pain on right side while sitting and running. A pain doctor examined me and thought it was probably lumbar facet nerve issue. MRI revealed moderate to moderately severe facet arthritis, but also mild spondy and mild disc herniation with mild stenosis. Back to the doc’s but saw nurse practitioner who said the cause is probably disc related. Scheduled epidural steroid injection. Does this sound reasonable?
I am a 74?year old male with chronic lower back pain! I’ve had nerve blocks and an ablation most pain is an ache when I sit mostly on left side I’m currently doing a back strengthening program pain still is there when I sit when I stand I’m pretty much pain free!! Can you please help me? Thank yup for your prompt and courteous reply! Sincerely Pat
I had the FRA done June 27th of this year and didn't get any relief to this day September 10th, 2024. I went for a follow-up about a month after, told the physician assistant that I was still having the lower back pain. I told her I didn't know if it was going to take longer for me to feel any relief or not. All she said was, " we will have you come back in 6 months ". So I go back and see my doctor in January 2025. I hopecmy doctor suggest doing the indoscopic RFA. I have Aetna/Medicare, so not sure if they will allow me to do the indoscopic RFA or not.
Would someone with bulging discs or stenosis be a candidate for ablation? I have been diagnosed with all of the above plus facet joint atrophy foraminal stenosis S1-L5, stenosis L4-5 and osteoporosis.....I'm feeling a little hopeless
Thank you for an excellent informative lecture! I have been in such pain lower back and constant pain in left buttocks 24 hrs per day for 3 years. Use ice and heating pad 24/7 for 3 years. Have had 3 MRI, 6 mos. PT, steroids shots, more PT, Xrays....no help but increase pain in buttocks. I had been walking for many years minimum 2 miles per day 6 days of the week. My work involved sitting and walking. Had 3 steroid shots: L3/4 ; L5; pimaformis muscle. Did not work. Had to quit my 2 mile walks 3 years ago. Tried 1/4 mile but so painful 2 hours later. Forced myself but have had to stop last 2 years. Doctor’s didn’t follow me after. Pandemic occurred. I schedule video visit with my spinal surgeon. He did another MRI. Said things about the same: mild degenerative disc disease. Told me it may be sacroiliac joint. Now, when I get up in the morning, I can hardly walk.. legs hard to move. Gets better 2 hours. Pain all day in left buttocks. Lower back pain. Cannot stand in one place more than a few minutes. Go grocery shopping and do light chores but have to sit on ice and heating pad. Went to another spinal surgeon. So I did all.... X-rays show “Severe Facet Degeneration of mid and lower lumbar”. PT I could hardly do (4 weeks)because the exercises were to tighten glut muscles in butt and aggravated too much the Pain in left buttocks. MRI not much different from previous. XRays were what showed a drastic difference in facet joints degeneration. So now I need to make an appointment with the surgeon since I have done what he asked. Do you think I have 2 things going on here, or 1. Just arthritis of lower spine and/or sacroiliac joint. Please kindly advise what I should ask surgeon, and do I am over 60.
I’m in the same situation as you; but I had ablation twice and it’s works! I like it better than epidural. Some days I’m in pain, but I feel much better. I’m thinking in doing the laser surgery.
I have a trapped nerve in the lumber area, It was through an accident, been 2& half years now, still waiting for treatment. Choice is a screw in area or a nerve blocker. Now other hip hurting because taking all the pressure, I am having an exray in this area this week. I have decided to go for the nerve blocker, which is months away. How good is the nerve blocker .
I’m fused C3-C6 and suspect my facets are inflamed through that area with the dizziness and pain at the base of my neck that radiates upwards and definitely would want the Longterm benefits of the endoscopic ryhzotomy as opposed to the short term ablations especially with the shorter recovery times and a better quality of life.
Dear doctor, thank you sooo much for detailed explanation. Just wondering would hyaluronic injection or PRP help with facet joint syndrome/arthritis as it helped you for SI Joint problem
Question--- what if flexion and extension cause pain and rate of "episodes" or " tweaks" to lower back become more frequent; even happening whilst in a course of PT? Do we proceed to some sort of needle adventure??
Great video and information. Thank you. I've had extensive and prolonged pain and discomfort for an extensive period of time. My history is far toooo long to list here - ha! I had a significant cycling crash in 2021 that took my back pain to an entirely new level and consistency. Last April I also had a microdiscectomy to reduce a herniated disc that smashed my femoral nerve. That was successful (unrelated) I have had bilateral RFA of the SI joint and L5/S1 Facet Joints. RFA had zero effectiveness, but the tests were very effective. 50 days ago had bilateral facet injections and in the last 3yrs that's been, by far, the most effective treatment. Pain is slowly returning. I know the nerves can't be seen, so the placement is not perfect with respect to an RFA and some times the nerves are missed. If another round of injections are favorable, but short lived, would a Rhizotomy be the next appropriate treatment? Appreciate you time and thank you again for a great video. Chris
I live just north of Tampa. I’ve had injections, blocks and ablation done. I cannot find anyone in my area that performs any type of MILD procedures. I have my MRIs and would love to have them evaluated. Thanks
Thank you so much. I feel better now. I'm not as scared now. I have to go get the nerve blocks soon in my lower back. Thanks for your explanation.
Any treatment any improvement
Thank you for explaining 100x better than my dismissive orthopedic surgeon!
my pleasure!
You are a Good Man. Don't Stop helping the sick. The World Needs more people like You
Best explanation I have seen on facet issues and ablations. Thank you for taking the time to put this together. I would have you do an ablation on me in a heartbeat 👍
Thank you!
I’m having the first of these procedures on Tuesday and I am so grateful for the exquisite explanation as I was very apprehensive until I watched it. Thank you for this informative series!
Glad it was helpful!
All doctors who do facet medicine should use your video for their patients
thank you!
I just completed my second MBB. I walked out of recovery room and walked 1.25 miles with no pain. Waiting for PA for ablation. I plan on walking and doing crunches everyday to lose the weight I put on secondary to pain and strengthen my core. It is nice to hear the same steps of the procedure and expected outcome from you that confirms what my physician has explained to me. I am looking forward to being pain free after 1.5 years post laminectomy.
I had RFA on my L3/4 L4/5 and L5/S1 . I only had relieved pain for 3 moths then constrain pain come back
@@tuyetaleisha8675 I'd try it again @tuy. May work better. Good luck!
Very thorough clinical explanation. Thank you much for caring enough to deliver this understandable important information. Very helpful 😊
You're very welcome!
Wow! Great explanations Dr. I’m a RN. I know an excellent Dr when I see one:)
THANKYOU
Just got a new MRI. First since 2018. Looks like I will be learning all about your topic. I have mild to moderate facet joint osteoarthritis on L1 through L5. Protruding discs. Neuroforaminal protrusion. Ligamentum flavum hypertrophy. Neuroforaminal narrowing.
I’m 65 and have worked and played hard all my life. I guess I’ve got to pay the fiddler.
Great info and presentation. Thank you.
Best video about facet joint pain on yt
I really appreciate these videos IM 62 male ive had L5S1 and my neck fused 7 years ago now im going thru this. Almost 1.5 years of hell Luckily im in pain management now and can some relief with minimal opioids during the day.I do believe my body is very slowly healing itself cause recently the pain seems to be moving up from my lower extremities to the lower back area part of the day anyway and recently ive been able to take longer walks without having to stop and sit down 😁
Thank you so much for that detailed explanation of the syndrome and the treatment. I watched so many videos related to this topic, but your video connected all the pieces of the information together in my head. Thank you for that
Phenomenonally helpful explanation. I'm inspired to do the PT exercise. If only all Physicians spoke with such clarity.
Your presentation is amazing! My wife has lumbar stenosis and degenerative disc disease. She’s in great pain and barely walks. I now understand how important it is for her to become more mobile for her health. We live in Michigan near Ann Arbor. I would have thought neurosurgeons here would have the same information you have, but her surgeon and pain management doc have never discussed any of the ideas you have presented. Is there any neurosurgeon in our area who is as knowledgeable and experienced as you?
There is no education in medical school of how to talk to people. THat is the real problem
How is your wife doing? I found a Dr office in Midland, MI. I'm getting this procedure July 17. 2024
51 yrs old. I don't know what to do first. I can't even stand up straight. My muscles stay sore 24/7 and this going on for abt 3 or more years now. 09 full tear in left knee acl and va said at my age they opt not do surgery, left me like that, 2013 hurt my back real bad heard a pop resulted in Spondylothesis in lumbar and facet hypertrophy and spinal stenosis severe exit foraminal stenosis and one fully collapsed hip and other hip partially collapsed hip. I keep getting told no one does backs. The va hip surgeon said let's settle down the back and do full back work up first and va just sent me to another hip surgeon who doesn't do backs. And back in 2016 va sent me to a neurosurgeon and he recommended trigger point injections and I still haven't gotten them either. Thank you DAV for giving me the zinger so I have a way to walk my dogs. This all started with Cervical injury in 2000. I have no pain in Neck th9ugh thank you Lord literally. I don't even know where to start to even help myself. The va is so bad. I can't take the pain anymore. Otherwise I'm healthy. Does that sound crazy or what. Somebody Please help.
Will be praying for you. 🙏🏽
@kingdavid3154 thank you. I can surely use that. Sincerely one day at a time sweet Jesus. We got this.
@@c.tucker95 Amén 🙏🏽
Maybe a cortisone shot?? I don’t know, that is what I am looking for at this point for my Facet Joints.
Wow wow wow - how educational. Had an MRI yesterday, found out about my facet problem. This is so informative! My ex died years ago after a neck operation so of course I’ve been nervous of course. But I am in much better shape than him so will actively work on PT.
Thank You so Much. You are the Only Person that explains this Process Thoroughly.
I Now have a better Understanding of what is going on. I wish YOU could Fix me Up. As The Word Says: You shall hear the Truth and shall Know it
I have had nerve block done, it confirmed median nerve at Facet joint but I am having hard time making decision on ablation. Great explanation, well done!
Best of luck!
58 y/o male here. had my first ablation 5 months ago and the pan is back to square 1. I have messaged my pain Dr today with your information. I hope he comes back with more than "well lets try it again and see what happens" Terrible painful process for only a few months of semi relief. Maybe 50% better for a fraction of that. Thank you!!
Terrible painful process? He said it was minimal at best?
FOS… it hurts
Dude! That was epic! Really good, well presented info. Really put my mind at ease! Thanks
Glad you enjoyed it!
Hi Dr McRoberts. HG here. Looking forward to my knee ablation in 2 weeks....then my cervical. Loved listening to your explanation...not so nervous now
Thanks for the "Education" it was brilliant, been suffering with lower back pain for a few years which has been diagnosed as multiple things with multiple solutions (none of which resolved the pain), recently I had a radioactive bone scan which highlighted the arthritis in the facet joints. In 2 weeks I go in for an RF Ablation, fingers crossed it provides some relief and after watching your video I am much more confident :)
Your presentation on this subject is excellent. Thank you for taking the time to make these videos. They are really helpful. I suffer from low back pain and in 2020 the Orthopedist said it was my Facet Joints. I had a steroid injection which helped but the pain came back. Then the orthopedist said I had SI joint disfunction. The next injection did not address my pain. Fast forward to 2023, with daily stretching and PT i am much better but still suffer with muscle pain. I will be seeing a new Pain management Dr. who performs the oblation and rhizotomy. I'm ready for anything that will help.
Absolutely, the best explanation I have ever heard. Thank you so much.
I have had the first sets of needles. The first two did not last very long at all. The ablation was the same. I t has been six months and I will being seeing my doctor next week and back pain is back to where it was in the beginning. The pain begins at my lower waist to my lower back just above my tail bone. I hope he will try the next procedure, I really need relief. Thank-you for educating me. I live in Northern Maine very close to the Canadian boarder. Wonderful info!!
I'm 69 and going to have a bilateral medial branch ablation at L4, L5, S1 on 6/18/24. The two diagnostic blocks gave me 80 to 90 percent relief. I'm looking forward to real back, buttock, and hamstring pain relief. If i have to have facet joints screwed for fusing, I'm hoping it's a few years out. I'll comment on my progress around 7/10/24. - Joe Frisina in PA
I'm 19 days post bi lateral medial branch ablations at L4,5, and S1. I feel that my relief is around 90% or better. Just some superficial sensations in my lower back and upper buttocks. My legs feel lighter, and it is easier to walk my 2 miles every other day. In between walking, my workouts at home are easier, too. I'm glad I had this done. - Joe Frisina
@@user-fq1xh7bg7gJoe_FrisinaPlease keep on informing. Your information about how long the relief lasts will be very helpful to many of us. My opinion: if it took the pain away, still be careful with workouts. Do them slowly, because the nerves swell with vigorous repeated movements. The nerves can swell and are compromised, although you don‘t notice it.
Thank you very much, Sir. Your video should be shown to all medicine students to each them how patient‘s information should be done. First of all, we need to be addressed as adults who can ask questions when there is something we cannot understand. Second, facts are less scary when explained with an empathic voice and good eye contact. Third, the best way to create a positive outcome of any procedure is by creating a safe environment.
Super informative and extremely well presented.
Thanks for sharing your knowledge and honesty I have a great deal of respect for Dr McRoberts I am under his treatments
I am under his wing as well…👍🙏💞👱🏻♀️
How amazing! I wish I could see you for my condition. Thank you so much. You explain it so well!
Tysvm for making this video. U hav helped me sooooooo much thru this video & friends. I am so very sorry about your mom. I loved this video & God bless you 4 taking the time to do this 🙏🙏🙏
You are so welcome
Earmuffs for the insurance companies at 17:00 ;) Great explanation of the MBB -> RFA process, Dr. McRoberts!
I had the first round cortisone and steroid injection done this way 2 weeks ago , I could feel the difference within 30 minutes. Booked for another injection in 3 days, my neurosurgeon said it should keep me pain free for up to 18months. Fingers crossed. I have also started physiotherapy to strengthen back muscles.
Having an ablation done next week. Once it is done can I attempt to not be a lazy American and do PT exercises that may help it last longer or even eliminate the issues?
I tell my patients to wait a week or two before resuming full activities.
Thank you for the enlightning information in this video. My understanding is quite a bit better now.
You are a mountain of information,thk you.JHB-SA.
Excellent explanation. It has helped me understand what is causing my back pain and treatment options for faucets pain.
Thanks so much for this great explanation! I am in the UK but am having the MBB and then hopefully RFA in the next couple of months. Literally can't wait as I can no longer sit comfortably in my recliner in the evenings.
Your video has inspired me to beg them to stick a bit of steroid in with the MBB 😂
What a brilliant video! Two years agoI had a spinal fusion of L5-S1. And somehow the surgeon when he was inserting the pedicle screws into my spine, accidentally put one into my facet joint. I’ve been in so much pain since the surgery. Tomorrow I’m going to the hospital to have a CT guided steroid injection to the area around that damaged facet joint. Hopefully, it brings some relief. I do feel a lot more positive now after watching your video. I thank you for that
Thank you for your great talk! I learned a lot and will be viewing your other lectures
Thank you! I see my Dr next week Re ablation consultation. I believe I will be a better informed patient. The best part is it may lead to a longer life because I can be more active physically. (I was an active runner; today a quarter mile walk and I’m gassed.)
I just had my first Medial Branch Block on April 10th and I got great relief, I had to grade my pain when I got home, doing household chores, and grade my pain each hour ,for 7 hours, then give a percentage of total relief. So right after getting off the procedure table, I had NO PAIN, then when I got home, I stood at my kitchen sink and did dishes, which normally couldn't stand no longer than 2 mins and the pain would show up, then I would have to sit down, so I did the dishes this time , was standing there for about 8 to 15 mins, had zero pain. Then did some vacuuming, had no pain, standing while dusting, so was only giving a grade of 1/2 on the 3,4, and 5th hour, then on the 6th hour I grade my pain a 1, and the 7th and last hour I graded a 2, which before my procedure I graded my pain an 8 ! And so I gave the total percentage of relief I got from having this procedure, I gave it 90% relief that I received!! So my pain doctor has me scheduled for June 3rd to have my second Medial Branch Block! I can't wait!! It was not bad at all! Just felt a little sting for about 3 seconds each time they were getting ready to numb me. So I didn't jerk, move or make any sounds. So hopefully after this 2nd Medial Branch Block, he will want to do the Radio Frequency Block. Your video I enjoyed so much, it explained so much that has went on with my Lumbar Stenosis and what to look forward to going forward. I am a 67 yr young woman..
Keep up the good work Doc!!
Sharon Carroll from Archdale, NC 🙂
Thank you for sharing I'm so glad to hear your review ,I have an appointment for MBB on May 2 coming up you and the Dr give me some strength to do it thank you very much 🙏
@@roseetienne222Good luck and hope it helps you as it did me!
Very informative, thank you!
I had the 2 diagnostic procedures done and had my first ablation 2 days ago (9/25/24)
I could feel the burning of the nerves “slightly” was very numb but could tell it was happening. The first day, I was sore, aching and had a slight, deep throbbing but moved gingerly throughout the day. I could only stand for short periods of time as my lower back would get heavy and begin to ache.
The following morning I was a little sore but as the day went on the soreness was lessening, I was amazed! I’ve had so many epidurals and facet blockers for so many years and was excited for this but also a little skeptical.
It’s been 2/3 days and I can barely tell I’ve had it done and have only experienced very mild pain compared to what I’m used to! Bottom line, I do believe this has and will continue to help quite drastically! For how long is yet to be seen and felt 🤦♀️
Excited to finally feel free of pain and hope this continues for a long time! Good luck to everyone, if anything changes I’ll try to update.
Thank you doctor for such a thorough explanation and helping to change so many peoples lives ❤️
Outstanding video. I have been watching several of your videos. You have taught me so much and helped me be more comfortable with the science behind pain management. I am suffering from low back pain and through yoga I have developed sciatic nerve pain. I will be calling your office to set up a consultation. I live in Jacksonville but want to have “good hands” working on my back. What are your thoughts about the ultrasonic bone scalpel? A video on that technology would be appreciated. Thank you for the education.
happy to help. thank you
I need to know more about”MILD”!
1:03
@@joanverbarg2529I had the MILD done on me Dec 30th, 2022, I have Lumbar Stenosis LR 4 and L5. It didn't help me at all. Only relief I am getting is sitting down when I am up and the pain flares up, I have to sit down to get the pain to stop. I am thankful for my pain management doctor, we had had to go through all the steps since he did the MILD procedure, just to get where I am today, because like this doctor says, the insurance companies have a "protocol " you have to go through, try other things before you have the major one that WILL help your pain. So I am scheduled for May 29th to have my 2nd Medial Branch Block, the first one he did April 10th and it helped me TREMENDOUSLY! So I am looking forward to May 29th for my 2nd one and then hopefully the next step after that will be the Radio Frequency Block 🙂
What happens to range of motion after fusion involving multiple levels?
Excellent video. Thank you for explanation of facet joints and the different options to help alleviate pain. I’m 45, Canadian and I was in a car accident in November 2014. I was rear ended by a distracted driver. Before the accident I was very active. I loved to dance. Now, I have
L5-S1 LEVEL: There is severe disc space narrowing with diffuse disc bulge and endplate osteophyte formation. There is also severe right-sided facet arthritis and mild left-sided facet arthritis. There is right- sided facet hypertrophy and ligamentum flavum hypertrophy.
L3-L4 and L4-L5 levels are not as severe, but there is disc desiccation, arthritis and disc bulge.
I have just done the steroid injection with success with pain free for 3 months. Now I’m waiting to do the ablation.
A very nuanced and thorough explanation. You have my thanks.
I have intractable low back pain that prevents me from running, bending over without support, let alone lifting heavy and moving normally. I have DDD at L4-S1.
I had a facet block last week that removed all of my pain for a day or two. I am going to get RF and see how long I get relief. This will be the second time around I get RF for facet pain, and if this time the relief does not last indefinitely then I will get surgery. I could get a fusion, but have been looking into disc replacement and I would prefer that option if it is suitable.
I saw a surgeon that specializes in disc replacement and his perspective is that disc replacement will eliminate my facet pain because my facet pain, in his view, is due to poor dynamics as a result of significant disc height loss (more than 50%) at L5/S1. My facets are only mildly arthritic in imaging. I wonder if you think his point of view could be correct.
Of course the safer route is fusion, but I would like to avoid that if I can.
This was extremely informative, thanks!
QUESTION Can any of these procedures mentioned be done for the Thoracic Area of the spine?
yes indeed. the thoracic spine is additionally amenable to facet denervation
I’m very grateful for the explanation
What about if I already have A cage from L3-L5, and now I have have severe spinal stenosis in L2-L3 on center canal & on left & right facet joints. And mild to moderate facet arthrosis and a shallow disc bulge on L1-L2? Can I be a candidate for a endoscopic rhizotomy? Pain on L2-L3 runs down my left side to my arm, knee. And chin? I did physical therapy 6 weeks and got an epidural which lasted about 5 days & was given from 300-600 Gabapintin which does nothing but make me tired. The inside of left knee pain abated some but never really left. After four days it was all back. Although PT has helped a lot, the weak thighs and knee pain are still here. I continue to do all the same physical therapy exercises that were taught to me at PT at home. I even got a stationary glute bike, and still the inner sides on my knees can’t touch as the left knee throbs, cramps & locks up when I try to sleep on my side. I use to walk 5 miles a week now I am lucky if I do three. I went to an orthopedic surgeon Dr M Barnum he wants to remove my L3-L5 - cage & 8 screws, and replace them with 10 - screws 5 on each side screws. A laminectomy fusion with instrumentation. I’ve Had three spinal fusions. It’s physical trauma on a human being along with the mental trauma of losing my 21 yr old son. I am 65 yrs old, he spoke to me like it was a breeze, a walk in the park. I’d be out in 2-3 days , walking immediately yada, yada, yada, perhaps he missed the part where I told him I’ve been there, done that & it’s not a walk in the park. So I won’t be going to him ever again. He is at Advent Hospital here in Florida. I will now go see a neurosurgeon at Orlando Health Dr Virgillio Matheus on 11/21 to hear what he thinks my options are. Wish me luck! Thank you for explaining the process, the procedures, medical terminology and even the difference on the insurance financial aspects and making that clear I get it. I’ve been in the behavioral health medical field for 28 yrs and ran a center in NYU Langone so I know about some of the things you spoke about. I know you won’t be able to directly answer me, but I wanted to thank you for giving me the knowledge I needed to ask the right questions. On 11/21/23 Millie Crespo
Recent MRI ruled out Stenosis. Pain also in left calf and ankle daily.
Are you familiar with the new procedure INTRACEPT PROCEDURE and what are your thoughts. Is it permanent or does it need to be repeated over time? I have spinal stenosis and my doctor who retired recommended this procedure. He stated it was permanent once and done, however; in looking up this procedure I’ve heard otherwise.
My pain doc now started recommending this now . Risk ?
I have osteoarthritis hip replacement at the age of 52. Ablations shots, Ive had it all. Now I’m having lower back pain. Just had an MRI showing spinal stenosis
I love following your journey and now I am your patient..💞🙏..I have been reading and following all of your extraordinary videos so thoroughly explained. I cannot wait until you attempt my back..I have 100% trust and faith in you and your knowledge and professionalism. I am enjoying learning everything about the spine, procedures and severity of it all..Thank you for all,of your passion and compassion for helping the quality of our lives…👱🏻♀️🤗💞🙏👍🥇🏩
Wow, thank you
@@wportermcroberts
Can a branch radial nerve trigger symptoms in the dermitoms in the foot or is it more so disc issue
Had 6 lumbar ablations last week to help with pain. Also have 17 degree scoliosis L2-3 from car accident years ago. One doc doesn't want to operate, another devised a fusion plan anchoring in my pelvis up to the 3rd from bottom rib to straighten everything and alleviate the lumbar lower thoracic pain.(Also have cervical stenosis that affects my arms/hands; neither doc wants to go there right now.) Will these "screws" work for combined scoliosis/stenosis? Thank you. 1/11/24
What about facet joints hypertrophy as the cause of pain and instability?
I get very bad groin, lower back thighs Buttox can’t walk far now spondylitis told to L4/5 S1 tried injections rubbish had leminectomey 50 years ago now had very bad fall that is how this is worse.😅😊 retired law enforcement old 71 worried now waiting for operation but just worried of uncome😮 excellent video
Can this be done after a fusion due to the hardware and heat?
Thank you for yhis great explanation. Do you recommend trying a spinal cord stimulator for facet joint arthritis
Thank you for the fabulous explanation. Ive got Bertolottis Syndrome and due to have blocks shortly. Im not as apprehensive now
54 years old. severe Facet hypertrophy. L3 L4, (L4 L5 also with central annular tear), L5 S1 with broad based disc bulge, Degenerative disease/multilevel diffuse disc bulge. Moderate degeneration of T11 T12 , L1 L2, L2 L3. I am being scheduled to have these facet injections. One thing that I heard you mention that does not fit my issues is that sitting helps with no pain. I am not like that at all. If I stand I get pain after short time, if I walk on concrete with my work boots I get pain quickly or at a mall with my good runners on! If I push pelvis forward it hurts or looking upward. My only relief is laying down and keeping inflammation to minimum. If I sit for long I get same lower back pain as standing. I also have mild scoliosis happening. I have hurt my back countless times over my career, I move 700lb tanks by hand for over 10 years. I hope these injections help me! I want to have a decent retirement and not be a crippled old man, I worked too hard to have my golden years taken from me.
Is the exercise ok with SI instability?
Explained well. Had epidurals yrs ago & didn't work after an injury. Just had 2 sets of shots with a fluroscope. Some relief possibly but supposed to get an ablasion if I decide to but not sure if it will help. Temporary from what I am told. L4L5 are gone & have bone spurs. 2 other discs are bulging. Stenosis & degenerative disc disease. Family trait. Don't want to end up like my dad. Helping a neighbor pull bushes, he felt something pop in his back. 2 surgeries & never walked again.
I had the vertiflex 5 weeks ago at L3-4 and L4-5. It helped the pain down my leg but I still have heaviness in my back and pain when sitting and standing. Oddly walking doesn’t bother me and never has. Before the vertiflex procedure my doctor gave me facet joint injections which worked so well but only lasted about 4 weeks. What would you advise? I live in Oklahoma City
Wow. Thank you for this information
Glad it was helpful!
Getting ready to do these procedures at UM in the next month or so. L5-S1 disk is gone. 1st step is the block, 2nd step block again then as you mention, ablation will be approved. Hoping it helps enough to avoid Fusion. Trying to avoid surgery at all costs.
How many times can you have ablation’s?
Excellent explanations, thanks.
I have facet joint arthritis with bone spurs plus stenosis in my lumbar spine. I am due to have this procedure. My question is will it work with stenosis? I am struggling to walk and stand which may be claudication, I also have cervical spine issues had acdf two levels last year but now c7 has moderate stenosis. My lumbar issues cause pain in my buttock pain down leg even my shin and ankle throb and get swollen at times, I’m confused best way forward for my treatment appreciate ideas you may have for me to discuss with my surgeon
I have been dealing with back pain for 20 years. I've had three MBB which lasted only a month. First time seeing a neurosurgeon and she has diagnosed my problem as facet joint arthritis, central canal is open. I also have a left "C" curve scoliosis in my lumbar spine complicating my facet joint instability. I'm hoping to get an appointment with a neurosurgeon specializing in deformity. I will certainly ask his opinion about the screw when/if I get that appointment. Thank you very much for this video.
Can you lift heavy after recovering from the screw implqnt?
most can return to normal activities.
@@wportermcroberts normal?Does that mean unrestricted or normal for them?
@@NaturalMeAmerica what exactly do you mean by "the screw implant?" I'd like to make sure we're chatting about the same thing. Thank you!
@wportermcroberts The procedure where you place a screw near the facet joint to hold it in place.
@wportermcroberts The implanting of a titanium screw on the facet joint. Can a person lift heavy weights and do heavy labor work after recovering from that procedure. And if so how long g would that recovery period last?
Awesome video! One question:
At 16:48 into the video, you describe that a steroid is often included with the numbing medication when performing a medial branch nerve block. That it is injected "right next to the arthritic joint" and that sometimes long term relief is achieved. Bit puzzled by that. I assume the inflammation is within the facet joint. How does the steroid reach the inflamed area. Is it adsorbed through the synovial sac?
Going through this now...
that is most likely the mechanism.
Great explanation!!
I had lumbar fusion 2-5 four years ago. Have had many injections, RAF,spinal cord trial, Peripheral nerve stimulation, scramble therapy ,laser treatment all to no avail . Nothing has helped ! My lower back still hurts every single day. I do take tylenol and hydrocodone to ease my pain. According to my recent MRI I do have bilateral facet joint arthropathy .
Very well done. I am a 61 female, lost almost 2” from 6’1, to 5’11. Dx spinal stenosis and degenerative disk disease and facet joint moderate arthritis. Bilateral hip arthritis is moderate. Had years of steroid injection in L5, then a new Dr said the bigger issue is the facets. Had two injections 11 yrs ago and was gold for years. Now, with weight gain, I’m pretty sore 80% of time. Social worker who walks, but now limited to distance as pain increases. This was so helpful to me as with most, who have significant back issues, I feel at a limit with pain and get fearful of what’s next, will it be more painful. THANK you for this video. I see interventional pain Drs soon in Idaho (live in small rural town in Oregon) and now feel like I have had a pre primer for the visit. Jane
Hi Doctor thank you for your help. My son have one of those injection to block the pain after a synovial cyst in his L4. After a month he start to have itchy in his leg can be relative to the injection ?
Thanks a lot doctor for this information. I've been diagnosed with facet joint synovitis for a few years and i didnt really know all the options available and how long could it actually take to feel relieve with all of them.
What if i put in the work on the gym? If i get stronger, build more muscle in my back and lower back and general build more muscle in my legs and body in general. Can this make it to the point of not being close to not need a fuse ever?
What would be the reason that a regular ablation is still considered above the endoscopic removal is the removal of the nerve is a longer relief up front? Insurance?
Hello doctor is facet joints is the same as spinal stenosis ? Also I have degenerative disc disease, I ve had so many problems in my lumbar and neck and I already had lumbar laminectomy surgery but pain its worst then before so what do you recommend to me? Thank you I love the way you explained everything step by step.
Thank you, Dr, this video was extremely helpful! 61 year old, marathon runner since 1980 and still going. I do regular core strengthening, including Superman. I rarely have back pain, but have developed glute pain on right side while sitting and running. A pain doctor examined me and thought it was probably lumbar facet nerve issue. MRI revealed moderate to moderately severe facet arthritis, but also mild spondy and mild disc herniation with mild stenosis. Back to the doc’s but saw nurse practitioner who said the cause is probably disc related. Scheduled epidural steroid injection. Does this sound reasonable?
I am a 74?year old male with chronic lower back pain! I’ve had nerve blocks and an ablation most pain is an ache when I sit mostly on left side I’m currently doing a back strengthening program pain still is there when I sit when I stand I’m pretty much pain free!! Can you please help me?
Thank yup for your prompt and courteous reply!
Sincerely
Pat
I had the FRA done June 27th of this year and didn't get any relief to this day September 10th, 2024. I went for a follow-up about a month after, told the physician assistant that I was still having the lower back pain. I told her I didn't know if it was going to take longer for me to feel any relief or not. All she said was, " we will have you come back in 6 months ". So I go back and see my doctor in January 2025. I hopecmy doctor suggest doing the indoscopic RFA. I have Aetna/Medicare, so not sure if they will allow me to do the indoscopic RFA or not.
Thank you for the great video!
Would someone with bulging discs or stenosis be a candidate for ablation? I have been diagnosed with all of the above plus facet joint atrophy foraminal stenosis S1-L5, stenosis L4-5 and osteoporosis.....I'm feeling a little hopeless
You mentioned it being a minimal costly procedure. Can you be more specific roughoy if one was to do it out of pocket please?
Ihave had my nerves burnt before in my lumbar limb.Is this the same as the facet joint ablation?
Would a block of the facet joint help with psoriatic arthritis of the lumbar spine? I suppose it would take 4 to 5 blocks to get all of these joints.
Very kind doctor. Wish I could change the fat to muscle around the joints, I’m sure that would help. Can’t seem to work through the pain.
Thank you for an excellent informative lecture! I have been in such pain lower back and constant pain in left buttocks 24 hrs per day for 3 years. Use ice and heating pad 24/7 for 3 years. Have had 3 MRI, 6 mos. PT, steroids shots, more PT, Xrays....no help but increase pain in buttocks. I had been walking for many years minimum 2 miles per day 6 days of the week. My work involved sitting and walking. Had 3 steroid shots: L3/4 ; L5; pimaformis muscle. Did not work. Had to quit my 2 mile walks 3 years ago. Tried 1/4 mile but so painful 2 hours later. Forced myself but have had to stop last 2 years. Doctor’s didn’t follow me after. Pandemic occurred. I schedule video visit with my spinal surgeon. He did another MRI. Said things about the same: mild degenerative disc disease. Told me it may be sacroiliac joint. Now, when I get up in the morning, I can hardly walk.. legs hard to move. Gets better 2 hours. Pain all day in left buttocks. Lower back pain. Cannot stand in one place more than a few minutes. Go grocery shopping and do light chores but have to sit on ice and heating pad. Went to another spinal surgeon. So I did all.... X-rays show “Severe Facet Degeneration of mid and lower lumbar”. PT I could hardly do (4 weeks)because the exercises were to tighten glut muscles in butt and aggravated too much the Pain in left buttocks. MRI not much different from previous. XRays were what showed a drastic difference in facet joints degeneration. So now I need to make an appointment with the surgeon since I have done what he asked. Do you think I have 2 things going on here, or 1. Just arthritis of lower spine and/or sacroiliac joint. Please kindly advise what I should ask surgeon, and do I am over 60.
I’m in the same situation as you; but I had ablation twice and it’s works! I like it better than epidural. Some days I’m in pain, but I feel much better. I’m thinking in doing the laser surgery.
I also had a blation therapy done twice years ago to my facet. Joints and recently to the SI joints. I had absolutely no relief the second time.
I have a trapped nerve in the lumber area, It was through an accident, been 2& half years now, still waiting for treatment. Choice is a screw in area or a nerve blocker. Now other hip hurting because taking all the pressure, I am having an exray in this area this week. I have decided to go for the nerve blocker, which is months away. How good is the nerve blocker .
I’m fused C3-C6 and suspect my facets are inflamed through that area with the dizziness and pain at the base of my neck that radiates upwards and definitely would want the Longterm benefits of the endoscopic ryhzotomy as opposed to the short term ablations especially with the shorter recovery times and a better quality of life.
Dear doctor, thank you sooo much for detailed explanation. Just wondering would hyaluronic injection or PRP help with facet joint syndrome/arthritis as it helped you for SI Joint problem
Question--- what if flexion and extension cause pain and rate of "episodes" or " tweaks" to lower back become more frequent; even happening whilst in a course of PT? Do we proceed to some sort of needle adventure??
Great question. Not necessarily yet: get a full set of flexion and extension X-rays, and then also likely too MRI.
Great video and information. Thank you. I've had extensive and prolonged pain and discomfort for an extensive period of time. My history is far toooo long to list here - ha! I had a significant cycling crash in 2021 that took my back pain to an entirely new level and consistency. Last April I also had a microdiscectomy to reduce a herniated disc that smashed my femoral nerve. That was successful (unrelated) I have had bilateral RFA of the SI joint and L5/S1 Facet Joints. RFA had zero effectiveness, but the tests were very effective. 50 days ago had bilateral facet injections and in the last 3yrs that's been, by far, the most effective treatment. Pain is slowly returning. I know the nerves can't be seen, so the placement is not perfect with respect to an RFA and some times the nerves are missed. If another round of injections are favorable, but short lived, would a Rhizotomy be the next appropriate treatment? Appreciate you time and thank you again for a great video. Chris
I live just north of Tampa. I’ve had injections, blocks and ablation done. I cannot find anyone in my area that performs any type of MILD procedures. I have my MRIs and would love to have them evaluated. Thanks
Do we exercise our back
I like the facet joint titanium screw as treatment. Longer lasting
Thanks alot. What about cancer risk from x-ray exposure when you require this procedure every year for the next 40-50 years?