Radiofrequency denervation
Radiofrequency denervation of nerves for
low back pain is becoming
more and more of an accepted treatment. In my experience very few people
receive long term relief with this therapy. In addition, this therapy makes
absolutely no sense to me. Let's see if it makes sense to you.
You have low back pain and to help rid it, the doctor burns the nerve that
is sending the signal that there is a problem in your back. So you don't
feel the pain anymore. The catch to this treatment though is that
typically, you still have some pain after this, albeit, just not as
much. But let's say you are one of the lucky ones that is helps decrease
your pain what is going to happen to you long term?
Let's see,
doctors used to and sometimes still give
cortisone shots. What was the
purpose of this? To get rid of the pain. But did the cortisone shot correct
the reason for the pain? I think not. So what happened? Your pain was gone
but the underlying damaged joint or low back tissue, continued. So you
continued to play racquet ball, run, do aerobics and all the other
activities of your active life. Because you couldn't feel the pain, the
body didn't cry out for pain until the day came when the joint was so
degenerated even the powerful
steroid injections couldn't handle it any more. Long
term effects of
anti-inflammatory and steroid injections were accelerated
arthritis.
What
is the long term consequence of knocking out nerves that were put there
to signal pain in a damaged joint? It physiologically has to be
the same. Imagine the fire alarm going off in your office as smoke is
coming through the vents and your boss takes out the battery of the
smoke detector? He tells everyone, don't worry everything is o.k.? You
would say, "You're nuts, I'm out of here!" He might stay but that would
lead to his death by smoke inhalation. The reason is the fire continued
even though the alarm was dismantled. Do you want the alarm system in
your low back or
neck dismantled? I didn't think so.
If you have low back pain and the doctor thinks it is your discs, he or
she will tell you that you have
discogenic low back pain. "I'm sorry
your discs are degenerated," they may say. "I recommend radiofrequency denervation." The patient may respond, "To make sure I understand, you
believe my discs are degenerated and they are causing my pain. But the
only I know this is happening is that I have this pain, you are going to
fry my nerves with some special probe? This will cost me and my
insurance company thousands and thousands of dollars. It will do
nothing to correct the reason my discs are degenerated will it doctor?"
Martha that is correct. If I was Martha I would next add "Doctor why
don't you denervate your own nerves then let me know how it goes a few
years down the line. I'm going to get
Prolotherapy and I'll let you
know how I'm doing in. Let me see I have free three years from next
Friday, should we call it lunch?"
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