@askpaindoc: Case of the Week 🩺 An 80-year-old patient came to me after years of chronic low back pain. She had tried multiple epidural steroid injections with zero relief, and was even told a spinal cord stimulator might be her only option. But her MRI showed facet joint arthritis. Instead of another epidural, I tested the tiny medial branch nerves with diagnostic blocks. She had 100% pain relief, twice. That confirmed the joints were the real pain source. Next step? Radiofrequency ablation (RFA) to gently “turn off” those pain signals. Months later, she’s still enjoying lasting relief and better function, without unnecessary procedures. Takeaway: Not all back pain is the same. The key is finding the right diagnosis, not just repeating the same intervention. #CaseOfTheWeek #BackPainRelief #FacetJointPain #ChronicPain #PainManagement

AskPainDoc
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Saturday 20 September 2025 14:21:13 GMT
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mindfulrnlisa
Nurse Lisa M. :
Epidural injections don’t work!
2025-09-22 08:43:52
7
rosaleeknapp
Annie :
I had both of those, didn’t work and gave me an abscess that put me in the hospital for a week and on IV antibiotics for 7 weeks. All of that just made my pain worse!
2025-09-21 19:28:40
8
bighullk3
quick silva :
how much
2025-10-14 17:51:44
0
paul58259
Paul :
Nice job... do you do this for whiplash pain?
2025-10-03 13:27:05
0
jd48130
Janeen :
Much younger but had the same procedures done just what you did for this lady. I also went so far as having the same nerve severed don’t recall the name of that procedure but it was basically severing the nerve and supposedly it cures for the rest of my life, which didn’t. Now I have the same pain as I originally did if not worse since I’ve been to pain mgt.
2025-09-21 10:49:50
3
susanhamm0
susanhamm0 :
uncle had that none and said it hurt him worse than ever and because he had that done they won't give him nothing for pain now
2025-09-22 10:08:59
3
clawskey17
Mooose :
Here’s a question/case study for ya. Involves T8-10 both sides. Slipping rib syndrome bilateral. Had no costal cartilage connection between 8-10. No relief from trigger point injections, nerve blocks (zero relief), all prior meds. I now have bioabsorable plates with tiger tape permanent sutures for rib fixation. nerves still fired up 2 years post op bilateral surgery from the expert surgeon on this (took meds for alittle while, I didn’t think the side effects from cymbalta or lyrica were worth the dependence on medication or side effects with their little efficacy in my case), yes I know this is a very rare issue. There was an option thrown out to try pulsed RFA or RFA. Cannot find reason on specialized CT, so most likely some level of neuroplastic pain to some degree. From your perspective, if I’m not getting any relief from nerve blocks (and actually increased my pain), would either RFA option still be a consideration in your opinion.
2025-09-21 01:07:22
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hootie315
Hootie 12 :
can you burn nerves if you have a cage in your neck and screws in your back L3-5. But am having the pain you are talking about with severe sciatica L5 S1 pressing spinal cord and nerves
2025-09-23 07:23:22
0
beachlife187
liz :
what doc would suggest a scs implant for an 80 yo i had mine implanted at age 50 and it was a nightmare
2025-09-24 10:33:49
1
lstew4
LStew4 :
I’ve had more epidurals than I can count along with radio frequency ablation- which was VERY PAINFUL……😳…… NONE OF THESE PROCEDURES HELPED AT ALL!!🤦🏼‍♀️😔
2025-10-04 01:21:23
1
mimilizz6
Liz❌️ :
I'm glad they worked for her they didn't work for me.
2025-10-10 13:50:11
1
kinddaily
Marine Chris TT Deals :
I’m looking forward to seeing more of your content .
2025-09-21 22:07:44
1
onlypawzzz
OnlyPaws :
Great case! Thanks for sharing
2025-09-21 01:19:49
1
diana.pena8
Diana Pena :
omg lord I wish you could help me be normal again. since 2017 I got the shingles and it left me with nerve damage I am in pain 24/7. that's what they wanted to do to me but iam scare. Do you think you could help me with this pain. the nerve damage is all my right middle side.front and back.
2025-10-08 22:24:45
0
rebecca.treadwell3
Rebecca Treadwell :
I am so glad that those worked for her. But I have had those injections, epidurals so many times, that I have scar tissue on my back, So bad that it hurts to go through the initial top layer of skin, because the scar tissue is so thick. and they never worked
2025-10-23 23:20:06
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snarahar
SatishN :
😍
2025-10-07 14:20:29
0
fruit_loooopz
🔥🏳️‍🌈Fruit_Looopz23🏳️‍🌈🔥 :
Nahhh screw all that medical devices an all that woo woo BS ✌🏻I almost di3d from the stimulator BLOWING UP in my spine & the shots made me go into DKA 🤷 I’ll stay on pain meds Thank you!
2025-09-21 05:32:44
6
tlm3309
tlm3309 :
Noooo. These blogs only last a short period of time and then you’re back for more needles and more needles no needles and no junk in my back. Thank you very much.
2025-09-21 13:52:32
2
stephanieb1979
StephanieB1979 :
Both blocks worked for me, but the RFA didn't provide any relief at all. It doesn't work for everyone, but opioid medications are safe and effective for 98% of people who take them. Isn't that amazing? 😁
2025-09-21 07:49:56
4
simplylivingwithwanda
Simply Living w/ Wanda :
Is this something that can happen when someone has had lumbar spinal fusion surgery? My son had that surgery two years ago due to scoliosis. This was supposed to help relieve poo pain but it didn't. He is still suffering with pain. He had two rounds of the 10- point trigger shots and the second one worked minimal, the first one nothing. The doctor seemed surprised that he didn't have better success. His pain management doctor had mentioned epidural but then said that wasn't an option because my son had a severe infection after his lumbar spinal fusion lumbar. Any thoughts would be appreciated. Thank you
2025-10-11 16:41:05
1
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