Denervation procedure

after having a small but good result from my facet joint injection i have now been advised by my MSK specialist to have the denervation procedure which should give me a longer period then the facet joint injection of pain relief.

i am a little be uncertain of this procedural but will go for the consultation to see what it all entails before making a decision.

Has anyone had this done and what sort of result did you find i know that everyone is different so i will of cause still keep a open mind

14 Replies

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  • Yes, I've had several sessions of bilateral spinal facet joint denervations over the years, since 1998 when I was first referred to my pain consultant for long-standing persistent spine pain. Although bulging, my discs were not impinging on either my spinal cord or major spinal nerve roots. Even so, a top NHS neurosurgeon actually gave me a date to come into hospital with my pjs & toothbrush for a last resort double cervical discectomy. I sidestepped this at the last moment, by insisting there must be some alternative...at that point he referred me to his colleague pain consultant. I had been coping with chronic spine pain for years by then, so my level of disability was relatively entrenched. Even so, with patience and perseverance I did manage to benefit from all the denervations and would definitely do the same again if I had to live my life over. I'm now 60.

    Before performing denervations, My pain consultant performed diagnostic injection blocks in all the joints he believed could benefit from denervations. I responded positively to these blocks, which he said established that I was a candidate for the denervations. Like you. But my vvvv experienced PC warned me that often, in chroinc pain cases like mine, the denervations procedures need to be repeated after several years. This proved true in my case. I had bilateral spinal facet joint denervations to all the joints in my neck twice: in 2 sessions over the years, and also 2 sessions of the same to my lumbar & sacrum joints.

    These procedures turned my life around. But I did have to go very gently during the 3 months of post procedure recovery, and work hard at physio over a long period. And learn how to lifestyle manage even my improved condition consistently.

    One note of caution. I've had to learn that sometimes treatment for chronic spine pain really can be extra extra complicated. 2 1/2 yrs ago, i consulted my PC about persistent foot pain. He recommended I be referred to a rheumatologist. My pc suspected an autoimmune condition might underly my chronic pain syndrome. Turned out I've had systemic Lupus all my life which has been progressing untreated. Once I started treatment for lupus my positive response was dramatic, with even the remaining vestiges of spine pain reducing significantly.

    I hope this helps. I'm passionate about the subject, so I can go on & on. These procedures gave me back my life - yes, I'm 60 now, and although I'm chronically unwell, I feel better than I hve since the 1970s!

    Please do feel free ask any me any questions you have. Yes, no 2 patients are identical, and yes your Consultant's approach may differ from mine, but at least learning about my experience may help a bit - I wish i'd been offered this sort of solidarity when I was having my first denervations procedure....I was vvvvv frightened!

    Take care & good luck

  • Please can you explain what denervations procedures are.& by whom & where they were done?

    I was recently discharged back to my GP from Hull pain clinic by a consultant who said he could do nothing to help me, on only the 2nd visit.

    I have had severe back pain for 40 years following a fall down stairs at work. have had 3 operations, the last a lumbar fusion 3 years ago @ QMC Nottingham who suggested a further fusion to mid thorax as I might have discitis, but I have heard nothing from them for 11 months! I was hoping to find an alternative, need to get some pain relief!!

  • hello carneed

    I could make a bold effort to answer your question, but this is a highly technical subject, so instead I did an online google search for 'spinal facet joint denervations' and, of the results offered me, I found this uk link one of the most satisfactory:

    pain-consultant.co.uk/pdf/P...

    just click on the link: it should work (I did test it just now). If you have trouble, try the same google search I describe above: you'll find this & other links that way

    I do so very deeply feel for you. You have been through a great deal of major treatment over many years. you may find that your awareness of denervations helps you to find effective treatment - perhaps not denervations themselves, but something involving that sort of pain technology.

    I wish you all the very best. Take heart: several times in my decades of searching for pain relief, stubborn, lazy or simply overworked & distracted consultants have told me they could do nothing to help me.....fine, I'd think, onto someone else....which of course is exhausting and depressing not to mention traumatising for any of us who live with chronic debilitating pain.....but, hey, at 60 I finally do live with less pain and better control of the pain levels I'm stuck with...but I think this will always be a one step & one day at a time thing

    Take care & good luck

  • PS i negected to reply to somethings you asked:

    who does denervations & where

    as I mentioned in my first reply to the original ? above, my denervations began in 1998. But they were all carried out by an NHS pain consultant, who is also an aneasthetist, working at a major uk hospital. I had been in a chronic pain state for 16 years by '98, so when he admitted the NHS waiting list for the first procedure was 3 years, my husband & I delved into our piggy bank to have this PC do all my procedures at private hospitals: this was very expensive, but worth every penny.

    My PC does denervations in an operating theatre with 2 nurses attending. In my experience these procedures are as technical as any operation. I was intravenously sedated for each procedure, but, as explained in the link I've given you, I understand the procedure requires that the patient is somewhat conscious....I actually have no memories at all of what happened during the actual denervation procedures! But I've been told some patients do remember...

    My impression is that these procedures are usually done by pain consultants working at NHS pain clinics, but many of these PCs are also at private hospitals

    I hope that gives you enough info to feel confident about looking further into this

  • Hello Barnclown, thanks for your reply & the link. I thought I would get decent treatment @ Queens Med, Nottingham, but I was wrong! I only moved to Hull from Doncaster a year ago so tried the pain clinic here, after seeing a surgeon privately who didn't recommend further surgery. I am very close to the end of my endurance. I really feel that doctors no longer care about helping their patients. I just need somebody to try something!! I can't find any oral analgesics that work for me, I need to find a good anaesthetist/ pain clinic and am prepared to go anywhere, but how do we find them other than by recommendation?

  • Yes. It's all very very hard. Recommendation is always desirable if at all possible, e.g. could a consultant who worked with you back where you lived before help? Some of my better recommendations have come about that way. On the other hand, I have hit the jackpot just by doing Internet searches for practitioners and studying their specialities.

    Have you joined the Backcare society? Am not sure whether they've changed their name. I was a member for years, until my Systemic Lupus was recognised They used to have a helpline...and may have consultants registered?

  • well got my consultation appointment for the above so here goes lets see what its all about and how long i need to wait or on the other hand he might feel i need something different who knows

  • You're right: check it out with him, see what he thinks is best....go away, think about his recommendations....see how you feel...maybe try another angle

    Am wishing you all the very best

  • Hello prim50, at least it seems you have found a Dr who knows about the procedure, all I ever get offered is acupuncture which does/nt work for me. I wonder which hospital /Pain clinic you are going to get this treatment please?

  • have been advised to have facet joint injection a second time but on both sides then see what result i get then poss have the denervetion is he think it worth it.

    not sure how all this will go down with work

  • All my 4 denervations sessions were bilateral (facet joints done on both sides of the spine - and I always at each of the 4 session, had several sets of facet joints denerved). So seems to me your dr is thinking hard about bet way of helping you...good luck...will be v interested to hear how you get on. Take care

  • Bar clown so happy to have found you, I too have a facet problem L3 & L4 just on the right side. I have been trying to control the pain with exercise and core strength exercises, this was all going well. Sadly for no reason my back got worse and felt very unstable and crooked I thankfully changed Doctors and now have a brilliant one who has diagnosed my fibromyalgia and the pain clinic are doing my first denerve tomorrow. I know we are all different but can I ask you how much pain were you in after the treatment. I know I will be wide awake and the whole procedure will be very painful but it has to be better than the pain I have been in for the last 4 years.

    What sort of after care would you recommend?

    So happy to of found you & thank you.

  • Glad you replied!  The procedure itself wasn't at all painful cause my pain consultant used the right mix of sedative (apparently I was conscious, but I have no memory of the experience at all), and in the denervation procedure itself he also used the right mix of steroids etc etc (he itemised listed the mix in his report).  

    After all my denervation procedures, I had nothing like the levels of pain I'd expected...quite the opposite (basically, the denervations numbed the pain I'd been living with for many years) but I did have to go vvvvv gently for several weeks...due to a kind of sore sensitivity & stiffness.  

    After one of my denervation procedures, I made the mistake of having a massage: BIG REACTION: had to go on prescription optiates & analgesics for weeks: dreadful mistake!  

    So my suggestion would be to ask your pain consultant about rehab & follow that guidance.  Myself, if I were to have more denervations, i'd just avoid weight bearing exercise, maybe do a wee bit of gentle stretching & after a few weeks look into the appropriateness of rehab from a physio who is licensed to practice IMS.  But my chronic longstanding (nearly 20 years) spine pain is hardly an issue now....

    Wishing you all the best

    🍀🍀🍀🍀 coco

     

  • Thank you for the message, I have now had my denerve procedure and it was ok.

    Yes it was painful, I was fully conscious I wore my earphones and listened to Simon mayos confessions to keep my mind off what was going on around me. Thankfully it worked to was able to keep relaxed and the whole procedure only took 40 minutes. I then had to spend 2 hours in recovery. I am happy to say I had no numbness after the procedure and 3 days on I am in very little pain.

    I am now planning on getting back to Pilates starting slowly and hopefully get back on my bike soon afterwards.

    I did put tape on my back and I have to admit this has been my biggest pain relief, I tried the morphiene patches and they just made me very sick.

    I also use a vibration pad to help relax my muscles and this really does help.

    Thank you all for your help.

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