Lumbar Ablation

[Doctor Steuss]

Has anyone here had a spinal ablation, or personally know someone who has, that wouldn't mind sharing your/their experience?

I'm wondering how much relief (if any), what recovery looked like, and how long it lasted before the pain returned?  While I have been able to essentially reverse the nerve damage I suffered from a herniation a while back, the bone spurs and endplate changes are something that there isn't really any type of "therapy" for, beyond pain management type things.  I've done pretty well on just NSAIDs, Tylenol, and physical therapy, until about 2 weeks ago. The pain seems to be progressing, and is now to the point where it's waking me up in the night, if I move at all... which makes me grumpy.

I can go back on opioids.  I'm not worried about addiction (I seem to have a low risk based on past experience).  What concerns me about relying on opioids is that over time it's natural to develop resistance.  Where I'm only 43 years old, and plan on living long enough to be a grandpa, that's a long time to have to keep moving up to stronger things.  Epidurals haven't worked, but facet injections have provided some relief, but they only last a few months at best.  Trying to gauge if an ablation would be worth a try.

[manol]

"Lumbar ablation" is a term I had to look up, and Google thinks it's a radio frequency/microwave-based procedure.  Is this what you mean?  Or do you mean a more traditional surgical procedure to remove bone tissue that is impinging on the nerve(s)? 

[Doctor Steuss]

16 minutes ago, manol said:

"Lumbar ablation" is a term I had to look up, and Google thinks it's a radio frequency/microwave-based procedure.  Is this what you mean?  Or do you mean a more traditional surgical procedure to remove bone tissue that is impinging on the nerve(s)? 

Google has not led you astray.  Radiofrequency ablation is what I'm thinking of getting.  They basically just go in, and nuke the nerves around the affected areas (in my case, S1-L4 vertebrae).  No nerves = Nothing to send pain signals.  From what I can find though (and what I've experienced in my recovery) is nerves (outside of the noggin) can and do grow back, so one of the things I'm wondering just how long it has provided relief for some "real world" people.

[Calm]

2 hours ago, Doctor Steuss said:

Has anyone here had a spinal ablation, or personally know someone who has, that wouldn't mind sharing your/their experience?

I'm wondering how much relief (if any), what recovery looked like, and how long it lasted before the pain returned?  While I have been able to essentially reverse the nerve damage I suffered from a herniation a while back, the bone spurs and endplate changes are something that there isn't really any type of "therapy" for, beyond pain management type things.  I've done pretty well on just NSAIDs, Tylenol, and physical therapy, until about 2 weeks ago. The pain seems to be progressing, and is now to the point where it's waking me up in the night, if I move at all... which makes me grumpy.

I can go back on opioids.  I'm not worried about addiction (I seem to have a low risk based on past experience).  What concerns me about relying on opioids is that over time it's natural to develop resistance.  Where I'm only 43 years old, and plan on living long enough to be a grandpa, that's a long time to have to keep moving up to stronger things.  Epidurals haven't worked, but facet injections have provided some relief, but they only last a few months at best.  Trying to gauge if an ablation would be worth a try.

I haven’t had one yet.  When I went in for the epidural shot, the doctor said she would recommend that as the next step.  The epidural is working relatively well after a month.  Facet injections did not work for me.  I am trying to get an epidural for my upper back now.  My issue is arthritis apparently.  MRI for that next week.

I am very interested in this as well.

Try to avoid opioids just in case it takes you to hyper analgesia.  At this point I don’t know how much of my pain is a result of pain and how much is hyper analgesia, but I don’t take opioids for pain, but for restless legs (it’s my entire body by now) and so far it’s the only thing that works.  If you get on opioids, you might try pushing for Subutex’s generic as my pain doctor says that causes the least roller coasting, he says some of his patients say their life is back to normal.  There are a couple of reasons I haven’t been able to take it yet, including insurance, but the doctor says there are discount programs.  Insurance says it’s for addicts only, the jerks.  It’s a major switchover.  I am hoping to try again in a few months.  Better to start out on it if possible.

Before I got the epidural, I assumed my pain was a side issue, something very annoying, but I could live with it just fine.  I cannot believe how much pain was actually intruding on my life, especially my mind.  The brain fog is much better now, I have slept through the night for a week before the storms hit again and pushed rls high.  I really hope you find something that works for you.

Edited March 29 by Calm

[Calm]

I do remember talking with some people who had multiple ones, but can’t remember how long it lasted for them and the email list we discussed it on is gone, so I can’t dig it up.  I would suggest going on FB and finding a support group and asking there.  I hate FB because long, informative discussions are highly unlikely, but there are a lot who gather there who will answer a simple question decently.

Edited March 29 by Calm

[Doctor Steuss]

Thank you so much Calm for taking the time to share your experience (and of course, the well-wish for relief is very mutual).

I will look at Subutex, because "chasing" the pain has definitely been a problem for me in the past when using opioids.  Take the pill, wait an hour for relief to start, get a few hours of feeling normal and being able to function, then a couple hours of being in pain waiting for the time when the next pill is allowed... wash, rinse, repeat.

I wish there weren't so many downsides with regular corticosteroid use.  Prednisone has been old faithful so far, whenever things get unbearable, but I can only do a few rounds of it a year.

[Bill “Papa” Lee]

3 hours ago, Doctor Steuss said:

Has anyone here had a spinal ablation, or personally know someone who has, that wouldn't mind sharing your/their experience?

I'm wondering how much relief (if any), what recovery looked like, and how long it lasted before the pain returned?  While I have been able to essentially reverse the nerve damage I suffered from a herniation a while back, the bone spurs and endplate changes are something that there isn't really any type of "therapy" for, beyond pain management type things.  I've done pretty well on just NSAIDs, Tylenol, and physical therapy, until about 2 weeks ago. The pain seems to be progressing, and is now to the point where it's waking me up in the night, if I move at all... which makes me grumpy.

I can go back on opioids.  I'm not worried about addiction (I seem to have a low risk based on past experience).  What concerns me about relying on opioids is that over time it's natural to develop resistance.  Where I'm only 43 years old, and plan on living long enough to be a grandpa, that's a long time to have to keep moving up to stronger things.  Epidurals haven't worked, but facet injections have provided some relief, but they only last a few months at best.  Trying to gauge if an ablation would be worth a try.

Oddly enough, I gave you a rep-point. At this post reminded me of your great quotes of Great men, on your signature lines, I had forgotten these quotes you list, as I have always loved them, when you post. Where I am reminded of these great men, and words filled with such wisdom. As for your post, take this advice, haven broken my back in May 2012, in three vertebrae, Opioids build up a tolerance, to the point, that 2 once did, soon will lead to 6, then 8, then 10. So it should be a last resort. However, I have had many surgeries, if you are married, or someone you know will be true to you. If you have either, let them lock them up, and give them to you, as does my wife of 48 years. Otherwise they can, or will consume you. Until one month, you will find yourself short of meds, by days or weeks. As all you want, is to not hurt. Pain can consume your life, or drive you to take whatever you need to just feel normal, painless, and whole again. God bless you in whatever path you must walk, as we are all different, in so many ways.

[Doctor Steuss]

Thank you Bill.  I'm sorry you've had to experience chronic pain.  It's wild just how much pain can consume us, and how easily we can forget what it was like, as our brain copes with the "memory" of it.

Quasi-related memory:   The imaging machine went down during one of my epidurals.  The needle was at the nerve when it went down, but he couldn't inject, and didn't want to risk moving the needle or pulling it out without imaging guidance, so I had to sit there with a harpoon hanging out in one of my neural foramen for about eight minutes while the machine rebooted.  I remember it happening, and I know it was one of the most painful things I've experienced, but try as I might, I can't remember any of the pain.

Our brains and bodies are miraculous... and weird.

[Calm]

2 hours ago, Doctor Steuss said:

I remember it happening, and I know it was one of the most painful things I've experienced…

I am not sure I am happy you shared this, lol.  Thanks…..

I will have to tell myself you haven’t gone through childbirth.

Edited March 30 by Calm

[Rain]

On things like this I like to go to reddit.  Google "lumbar ablation reddit" and you can find lots of people who have experience. I wouldn't necessarily go to them for good medical answers, but hearing experiences can help you decide. I did it when I got my tonsils out as an adult and it was so helpful.

[champatsch]

You might have already tried a dietary intervention, but in case you haven't, it could be an additional thing to consider adding to a pain-reduction regimen.

An orthopedic surgeon, well-known in the carnivore space, hurt his neck doing jiu-jitsu last year. He cited studies on ketosis reducing neuroinflammation, which can lead to pain reduction, but probably not elimination in your case. To stay in long-term ketosis requires, however, a diet which is 80+% fat, 20-% protein, 0% carbs.

He said he didn't really like the dietary shift to more fat, but that it did give him pain relief, and shortly thereafter he reported full recovery from his nerve pain. You might know who I'm talking about it, since he is a world-class age-group (natural) weightlifter, and age-group concept 2 rowing world record holder.

[Calm]

1 hour ago, champatsch said:

his nerve pain

Isn’t inflammation due to injury something different from inflammation due to bone spurs though? Plus Dr Streuss has mentioned he has already dealt with the nerve damage (he mentioned in another post using peptides).

It would be wonderful if diet could lower pain resulting from bone spurs pushing against nerves, but other than removing the bone spurs or suppressing nerves, what else can be done? (Serious question as if there is, I want to know for future reference)

Edited March 30 by Calm

[Doctor Steuss]

On 3/30/2024 at 6:42 AM, champatsch said:

You might have already tried a dietary intervention, but in case you haven't, it could be an additional thing to consider adding to a pain-reduction regimen.

An orthopedic surgeon, well-known in the carnivore space, hurt his neck doing jiu-jitsu last year. He cited studies on ketosis reducing neuroinflammation, which can lead to pain reduction, but probably not elimination in your case. To stay in long-term ketosis requires, however, a diet which is 80+% fat, 20-% protein, 0% carbs.

He said he didn't really like the dietary shift to more fat, but that it did give him pain relief, and shortly thereafter he reported full recovery from his nerve pain. You might know who I'm talking about it, since he is a world-class age-group (natural) weightlifter, and age-group concept 2 rowing world record holder.

Thank you Champatsch for the suggestion.  Unfortunately, my family has a history of heart disease, and I am predisposed to high cholesterol.  I have to keep my saturated fats near zero, which all but knocks out most animal protein.  That said, my diet is pretty on-point, as far as diets go.  I'm 6', 280 pounds (down from 300).  260 is where I generally have visible abs, but I am probably going to drop down to 240 this go around, and just sacrifice the muscle mass for the greater good of pain relief.

I do take fish oil, and grapeseed oil daily though, for polyunsaturated fats, after reading a study on its effects on neuropathy.  Seems to have worked a little magic.

My problems are a mix of arthritic inflammation (arthritis, bone spurs, endplate changes on multiple vertebrae), degenerative disc disease, foraminal stenosis, central stenosis, etc., etc.  The current source of pain is from several rascally vertebrae that are starting to have unchaperoned cuddling sessions.  A combination of bone spurs, and endplate growths, and the discs being ridiculously thin.  So, the rascals are making out, and getting all hot and heavy, and the nerves are feeling mighty awkward having to be witness to it all.

[Doctor Steuss]

On 3/29/2024 at 5:07 PM, Calm said:

I am not sure I am happy you shared this, lol.  Thanks…..

I will have to tell myself you haven’t gone through childbirth.

Yeah... based on how I generally react to stubbed toes, I am pretty sure I would literally die in childbirth.  Like, full on, give up the ghost, I'm not doing this, dead.

[Tacenda]

2 hours ago, Doctor Steuss said:

Thank you Champatsch for the suggestion.  Unfortunately, my family has a history of heart disease, and I am predisposed to high cholesterol.  I have to keep my saturated fats near zero, which all but knocks out most animal protein.  That said, my diet is pretty on-point, as far as diets go.  I'm 6', 280 pounds (down from 300).  260 is where I generally have visible abs, but I am probably going to drop down to 240 this go around, and just sacrifice the muscle mass for the greater good of pain relief.

I do take fish oil, and grapeseed oil daily though, for polyunsaturated fats, after reading a study on its effects on neuropathy.  Seems to have worked a little magic.

My problems are a mix of arthritic inflammation (arthritis, bone spurs, endplate changes on multiple vertebrae), degenerative disc disease, foraminal stenosis, central stenosis, etc., etc.  The current source of pain is from several rascally vertebrae that are starting to have unchaperoned cuddling sessions.  A combination of bone spurs, and endplate growths, and the discs being ridiculously thin.  So, the rascals are making out, and getting all hot and heavy, and the nerves are feeling mighty awkward having to be witness to it all.

Well, you're a step ahead with such a funny/great attitude about it. They say the mind can do amazing things. One thing I saw recently is doing the intermittent fasting thing too. But I shouldn't be giving out info that might interact with what you're doing now. My brother had something done that I think is the procedure you're thinking of doing. I need to reach out to him and ask about his experience. I'm not that close to him, wish I was. I guess I feel perturbed that I'm always the one calling him, and he never reciprocates. 

Edited April 1 by Tacenda

[Calm]

3 hours ago, Doctor Steuss said:

do take fish oil, and grapeseed oil daily though, for polyunsaturated fats, after reading a study on its effects on neuropathy.  Seems to have worked a little magic.

I have burning feet neuropathy.  I take a concentrated omega 3 for that. It has nicely controlled it till the last 4 months or so.  I  can tell when I have forgotten it more than a week as the burn gets painful rather than the usual background buzz.

It has gotten worse lately.  I am thinking of adding alpha lipoic acid as it was very helpful before.  Hesitant because last times I have tried it, it made me dizzy, but I am hoping that is because of another drug I rarely use these days.

Edited April 1 by Calm

[Doctor Steuss]

51 minutes ago, Calm said:

I have burning feet neuropathy.  I take a concentrated omega 3 for that. It has nicely controlled it till the last 4 months or so.  I  can tell when I have forgotten it more than a week as the burn gets painful rather than the usual background buzz.

It has gotten worse lately.  I am thinking of adding alpha lipoic acid as it was very helpful before.  Hesitant because last times I have tried it, it made me dizzy, but I am hoping that is because of another drug I rarely use these days.

I am so sorry you're having to deal with that.

I don't know if it'd make a difference, compared to a straight-up concentrated ALA supplement, but ground flaxseed might be worth a try.  I add a tablespoon of it to my morning, and evening shakes.  The texture can be a little off-putting at times, but I've personally never experienced any adverse effects.  Also has the bonus of some added fiber.

The brand sold at Trader Joes is the finest blend (and least "gritty") that I've found so far.  Every flax/chia mix I've tried is like trying to swallow sand.

I've been on a pretty high fiber diet for a long time, so if you go this route, you might have to start with a bit smaller amount, and work your way up, if upping your fiber intake makes you have a southern symphony.

Edited April 1 by Doctor Steuss

[Tacenda]

7 hours ago, Calm said:

I have burning feet neuropathy.  I take a concentrated omega 3 for that. It has nicely controlled it till the last 4 months or so.  I  can tell when I have forgotten it more than a week as the burn gets painful rather than the usual background buzz.

It has gotten worse lately.  I am thinking of adding alpha lipoic acid as it was very helpful before.  Hesitant because last times I have tried it, it made me dizzy, but I am hoping that is because of another drug I rarely use these days.

My good friend suffers with burning feet from neuropathy as well. I'm always looking for her cure. Sorry for both of you Calm. On top of all the other things, you have to deal with this? No fair! 

[Calm]

3 hours ago, Tacenda said:

My good friend suffers with burning feet from neuropathy as well. I'm always looking for her cure. Sorry for both of you Calm. On top of all the other things, you have to deal with this? No fair! 

It is typically a minor annoyance thank goodness.  When I have my shoes on instead of slippers I have to think about it to notice it…as long as I keep up with the Omegas.  I do worry about it getting worse with time.  At least it seems to be restricted to my feet.  They terrified me when it first started that it was going creep up into my legs, hands and arms, etc.  Nope.

Thanks for the recommend of flaxseed, Dr.  .  I got some online and quite awhile later most of it hit the garbage.  Just didn’t seem worth it.  Trader’s Joe it is.

[Calm]

Is this it?  I thought I was going to have to send my husband on a grocery run…

https://www.amazon.com/Trader-Joes-Organic-Gluten-Flaxseed/dp/B01LOXHZ2C

[Doctor Steuss]

8 hours ago, Calm said:

Is this it?  I thought I was going to have to send my husband on a grocery run…

https://www.amazon.com/Trader-Joes-Organic-Gluten-Flaxseed/dp/B01LOXHZ2C

Yep, that's it. 🙂

I've never tried the recipe on the back, but I've had two separate cashiers mention it, and how they like it -- if the shake route is too hard to get past.

For some reason, my pea protein / rice protein blend seems to mask the texture better than whey.  I think if the shake itself is a bit "thicker," it makes the flax bits almost unnoticeable.

ETA:  If you do like, it and it helps, a future grocery run will be a bit cheaper.  I think it's somewhere between $5-$6 a bag in store (if I remember right).

Edited April 2 by Doctor Steuss

[Tacenda]

10 hours ago, Calm said:

Is this it?  I thought I was going to have to send my husband on a grocery run…

https://www.amazon.com/Trader-Joes-Organic-Gluten-Flaxseed/dp/B01LOXHZ2C

I must have read a while back how flaxseed helps, but it was for something else and went out and bought it at a grocery store. I sprinkle it on my cereal in the mornings when I remember. Now I'll be more diligent in doing so, because of the benefits!