Ask Dr. John

Back Pain

Anonymous: "I have constant back pain. I had surgery in 2000. My doctor recommends RFA from the tests I've had and I am very leery. What's your opinion?"

RFA is Radio Frequency Ablation. It's a relatively new technique that uses radio frequency waves to head the tissue and destroy nerves that carry pain signals. It's being used to treat back pain and is what's known as a minimally invasive procedure. In other words, it's not a surgery in the commonly known sense but involves inserting a needle near the nerve causing your pain and using radio frequencies to heat it up. Although it's a relatively safe procedure, it, like any procedure, can have side effects. These include permanent numbness. You can also develop neuritis, or an inflammation of other nerves in the area being treated. If this happens it usually goes away after a few weeks, but sometimes requires further treatment. Another side effect is the development of a neuroma. That's a mass that forms around the destroyed nerve. This is a rare side effect but can lead to a worsening to the problem that also requires more treatment. And like any procedure involving going through the skin, there is the possibility of an infection. Although these side effects might sound scary, the vast majority of those undergoing this procedure have not had these problems and are glad they did it.

Elisabeth from Pueblo West: "About two years ago, I had a spinal fusion done on my lower back. About four months after my surgery, I started feeling so much better than before the surgery, but since about October 2009, I am in so much pain and this pain is very different. It starts in my lower back and goes down my buttocks. It comes on without warning. What do you think?"

I think you need to see your doctor about your back again. A couple of things could be going on that are either a direct result of your surgery or something that would have come up anyway. After surgery you build up scar tissue. That tissue can cause pain to return and possibly even worsen. Depending on the type of surgery you had, you also could have formed what's known as a neuroma. This is a nerve tumor that can also grow and cause pain. But it's also possible you are having pain because of an entirely different problem, one not related to your previous back issue. Regardless, when you have back pain that radiates down your leg and seems as intense as yours does, it's time to pay a visit to your doctor again.

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