Ablation or transforaminal injection?

@golfer18 Did you ask the doctor what an ablation is? From my understanding, an ablation destroys something that is malfunctioning as a way to remove it. A transformational injection would be to introduce a steroid to reduce inflammation as a temporary treatment for pain.

A radiofrequency neurotomy is an ablation of a nerve. This link gives more information. It does say that it can treat pain in buttocks, but not below the knee.

Your doctor is the best one to explain his choices in your treatment. Can you send him a question on a patient portal?

Your doctor is definitely the one to explain, although the above information is pretty helpful!

I just had rf done 3/4, 4-5, 5-1. 6 places, one on each side. Not even two weeks ago.
Have/hopefully had, severe pain in butt, pudendal nerve, lower back, hamstrings both sides that wrapped around to the front of my thighs. Needless to say, have tried everything for years, injections, meds, pt you name it. For years. Finally had to do it.
Insurance/Medicare requires two sets of test injections, to make sure the doctor has the right spot to burn the nerve. Tests not painful. As I understand, the test injections may provide relief for a little or long time. Also, as I understand, as long as some relief is provided, regardless of how long it lasts, that is counts as a successful test. According to 3 different pain management doctors I spoke to about this.
Your doctor may have a different opinion, so his word is the one that counts.
My procedure relief did not come immediately, but seems to be sneaking up slowly in all areas. I was so happy that they told me that, because I would have been depressed…
I was awake for procedure, and doctor was asking me questions about how things felt, or that there may be a strong discomfort that would be over in a few seconds. True. I think looking for the perfect spot in some areas. Will ask him at follow up.
There are doctors that will put you under, was hoping for that, but I can totally understand why being aware was helpful for guiding for the procedure.
I know that this will be a continuing process, but now that it’s done and I know what to expect, I’m not afraid of it. First night was nasty, after that just sore for a week.
Pm me if you have questions!
Find your fix…😘

Thanks

I am interested in your procedure, as I am having the same done in the near future.
But, have had several shots done in the past that did nothing at all to relieve my pain. I was put under, thank heavens, as the first procedure I was awake & was extremely uncomfortable to say the least! I guess I am a big baby about pain, having been subjected to so much of it because, as you are well aware, sciatica pain is so constant and so awful.
The right spots for me are very easy for me to pinpoint, I can easily touch them with my fingers.
Any PRACTICAL help for me or what to show the surgeon would be wonderful.
Thanks so much.

Mermaid, To start, the doctor I chose does not put you out…I was a little freaked, but only a couple moments that were not good, and was warned in advance, and told would be over in less than 10 seconds. Was probably 3-4 seconds once I told him it hurt. Could handle that…probably still hand marks in the edge of the table…
There is a clinic I could go to with great docs, but 45 min away, interstate driving. They put you out for everything!🤣
I opted to try and stay closer to home, it was 3 trips for every test, procedure etc. If I couldn’t handle next one, can always go there.
Enough about me…
If you have a medical professional, even pelvic pt, or urologist or chiropractor ( wear yoga type pants!) that you could see, explain to them where it hurts, have them press on the areas that bother you, to make sure it is the right spot, then have them write down the medical name for each of every nerve, tendon, muscle, bone etc etc, then take that info to your next appointment. Doctors typically will not do that.
It will give the doctor a pretty clear idea of the cause of what hurts. I was tired of saying my back hurts, my butt hurts etc. I was desperate and came up with that idea. Has helped twice! I have a terrible spine, and everyone attributes my pain to my spine…but what piece, part or degenerative thing causing pain every where else?
So, ablation is different from shots as you know, and they do need to find the right spot to treat in order for the procedure to be successful.
Have you had the 2 sets of test shots needed for ablation? Different from pain management injections.
As I understand, you only need a small amount of time for relief, to know if they are in the right place. I was told could be a very short (minutes-hour?) or long period of time.
They treated nerves/arthritis in/next to? my spine, and had test success for some spine comfort. Did nothing for legs, butt, pudendal nerve etc.
When they did the actual ablation, was told by several docs that could weeks or longer for relief in other places. They were right and glad they told me that.
Maybe a week after, started to feel some comfort just creeping around, coming and going, kind of 2 steps forward and one step back.
It’s been two weeks and I am starting to feel a little better every where that hurts 😁
My doctor suggested using diclofenac PATCHES, RX, up to three at one time in the treatment areas or anywhere for pain. Wear them starting at least the day before or morning of your procedure.
Only over the counter meds for pain. Start right away, before you feel anything.
I take low dose naltrexone for pain management, because I wasn’t put out, and the dose is so low, he said I could continue to use them. If it’s something you use, it could stop the anesthesia from working properly.
I stopped a week before, just to be safe!
Hoping to drop from 4.5 to 3…stuff not strong at all, but don’t want to take meds.
The first night was hard, because things really kinda hurt. And couldn’t sleep because they use something (forget name) that is mixed in with everything that really keeps me, at least, awake. Then was just finding a comfortable position to rest, sleep etc, lots of soft pillows.
Did I forget anything 😂 ? Pm or just post again and I will try to answer your questions!
❤️

Mermaid, I’m not sure of when your procedure might be, but I will try to get some info from my doctor when I see him for follow up in two weeks. I did ask him after, what he worked on and he said arthritis.
I know he worked on 3-2, 2-1, 1-5. Each side, so total of 6 ablations. Don’t think he worked inside spine. I will be more specific with my questions!
Procedure doc, my Med pain management doc and also my orthopedic doc all mentioned (unasked for) that the ablation for spine might also help my butt, pudendal nerve and the hamstring pain that wrapped around to the front, both sides. All feeling a little better…🙏
What is he treating you for? Just nosey-we may have totally different issues…I never had any injections INTO my spine that I am aware of…but will check in couple weeks.
Did you discuss ablation and then rule it out?

Many thanks to you for great practical advice and "blow by blow" of your experiences.
I will get back to you soon, ----this week is full of medical appointments & other necessary trips here & there.
Short synopsis is arthritic condition in sciatica joint.

Am I able to send you private message, would prefer that?!