Back and neck pain are common afflictions which, by report, cost the United States millions of dollars in lost work time and medical costs each year. Those who suffer from chronic back and neck pain often must limit or give up activities they enjoy. While frequently due to car crashes, such pain can also be caused by many other factors. Medical science is still trying to identify and treat the cause of such pain.
The American Medical Association itself is recognizing the long-term implications of ongoing chronic pain. An entire chapter is devoted to this in the AMA Guides to the Evaluation of Permanent Impairment. In car crash cases, the insurance industry routinely hires doctors that ignore this growing body of medical science and, without any real factual or scientific support, claim all injuries heal within 6-12 weeks.
There is a growing subspecialty in medicine of pain management utilizing therapy and various procedures short of surgery to deal with ongoing pain. These often involve injections that serve both a diagnostic and therapeutic purpose. Many people, who are frustrated with attending physical therapy or chiropractic appointments, experience ongoing pain despite performing exercises and using over-the counter or prescription medications. These people often become frustrated with the inability of their doctors to determine a definitive cause and solution for their pain.
One potential treatment that is gaining more acceptance is called “radio frequency neurotomy” or “rhizotomy.” I just underwent such a procedure for my low back pain and have enjoyed 75-80% improvement in my symptoms. The procedure took about 30 minutes and I was able to return to work and my activities the following day. I received a mild anesthetic and was awake during the procedure. The pain was certainly tolerable, not being any more than a paper or shaving cut. It was certainly less painful than what my kids went through to obtain their tattoos.
The physiology underlying the procedure is found in the facet joints which are formed by the bones or vertebrae in the spine. If this is injured, a pain signal is sent through at a very specific nerve to the brain. If a doctor suspects that a facet joint has been damaged or injured, he or she orders median branch blocks. This consists of injecting a pain killer into the suspected sites to see if the pain is reduced for the expected period of time. If the patient receives appropriate relief following these blocks, she then proceeds to the radio frequency neurotomy.
During the procedure the patient is first given a sedative. She is awake during the procedure during which the doctor uses fluoroscopy (x-ray image displayed in real time on a monitor) to guide the needles to an appropriate location. The doctor then stimulates the nerve to make sure that the proper nerve has been identified. The doctor then places two probes alongside the nerve at a proper angle and distance between them. Electrical current is then introduced to heat up and burn away the covering or sheath that surrounds the nerve.
If the procedure is properly done and the underlying diagnosis of a facet joint injury is correct, the procedure can provide 80-100% relief for 8-12 months. The procedure can then be repeated after the nerve sheath regrows.
This procedure is not for everyone. It will not be effective if the pain is coming from a source other than the facet joint, such as a disc or ligament injury. However, having undergone some of them myself, most recently at CDI (Center for Diagnostic Imaging), I have noticed an improvement in my pain and will definitely undergo them again. The pain was certainly tolerable and well worth it for me. You can contact me at 763-783-5121 or via e-mail at firstname.lastname@example.org if you have any questions.
~ John T. Buchman
Person Injury Attorney