Rhizotomy Side Effects: Killing Off Important Stabilizers

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rhizotomy side effects

Radiofrequency ablation or RFA (also known as rhizotomy) has become a mainstay of low back pain treatment in the U.S. and elsewhere. However, what if the list of rhizotomy side effects held a secret that most patients never knew about nor were informed of as a possibility. What if everyone who got a successful RFA had this serious side effect and that will likely make them worse off in the long-run? Would as many patients sign up for this common procedure? Let me explain.

RFA or rhizotomy involves precisely placing a specialized needle near the nerve that takes pain signals from a painful low back facet joint. These joints can become painful when the patient’s low back discs begin to loose height and more wear and tear is experienced by these joints or when these joints are injured. The procedure works by the tip of the needle heating up, which literally burns the little nerve away (ablates or destroys it). While one function of the nerve is to take pain signals from the joint to the brain, another is to supply the important stabilizing muscles of the back known as multifidus. These little muscles are critical for normal back function, as they control the movement of one vertebra on another. When the nerve is ablated, these muscles suffer. How much can they get damaged by killing their nerve? The image above tells the story.

This image is from a patient we treated in Grand Cayman patient where we use our advanced cultured stem cell procedure at our our licensed site there). He’s had several RFAs on the right (left side of the picture above). The white dashed circles are around the multifidus compartment. The dark color is muscle, the white color is fat atrophy (meaning dead muscle). Notice how the circle on the left of the picture (right on the patient) is filled largely with white, which is muscle that has been killed off by the RFA. Compare this to the other side without the RFA which is still alive and dark. So while RFA took his pain away for 6-12 months at a time, it also set his back up to be unstable and unprotected. Will these muscles grow back? Unlikely in my experience.

The upshot? RFA is a destructive procedure that we AVOID in our practice. It’s the opposite of a regenerative medicine procedure. Today, given how well platelet rich plasma or stem cells work in these small joints, there’s simply no reason to destroy nerves in a patient’s low back. Hopefully, this is the beginning of the end of this procedure and the next generation of doctors will look back in horror and say, “What were they thinking?”

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This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.

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25 thoughts on “Rhizotomy Side Effects: Killing Off Important Stabilizers

  1. BL

    I spoke to a rep for “Coolief” and asked if, for the knee, whether it effects motor function and I was told no, it only affects sensory nerves. Do you think that is correct??

    1. Regenexx Team

      This is a question for one of our Physicians. I have inquired and will get back to you.

    2. Regenexx Team

      I did ask one of our physicians, and their reply was: “NO experience with this unit, buy it likely doesn’t impact motor nerves.”

  2. Helen

    I’m supposed to have this procedure done on April 5th . I’m not to sure now. I don’t want to lose any mobility . The pain really affects me when I get up and walk from sitting, and when I’m laying down, I can only lay on my back , If I lay on my side. it feels like a knife is going in my low back . What do you think ? Ive always heard your nerves alert you to a bigger problem.

    1. Regenexx Team

      It’s not something we recommend, as killing off nerves has consequences. The problem can be treated instead with your own stem cells or platelets to repair and heal. Please see: https://regenexx.com/the-regenexx-procedures/back-surgery-alternative/ Here is a list of Regenexx Providers: https://regenexx.com/find-a-physician/

  3. Tracie Byers

    I messed up my left foot and ankle in a fall. The surgeon was supposed to go in and connect the small and large tendons in my foot to give my ankle more support. During surgery he saw that my small tendon was very damaged. He cut it out! My pain/problems increased. Today another doctor did an ultrasound and emg. He discovered that 2 nerves were damaged. 1 from the fall, the other from the surgery. He said only 20-30% of the nerve is working. He recommended killing that nerve. Needless to say, I’m very apprehensive.

    1. Regenexx Team

      Thankfully you’re apprehensive regarding such an irrereversible plan, as there are other options. In a case like this, it’s definitely worth trying to perform platelet lysate hydrodissection before killing the nerve. Please see: https://regenexx.com/blog/radial-nerve-treatment/ If you’d like to see if you’d be a candidate for this type of procedure, please submit the Candidate form.

  4. Stacy

    I had a couple of Rhizotomies done about 5 years ago I also have MS and had Brain surgery in 1997. My entire right side has been somewhat numb ever since my brain surgery, however in the last few months the right side of my back has become majorly numb. So much so that I feel nothing. Could this be from the Rhizotomies years ago or do you think it’s the MS?

    1. Regenexx Team

      These are questions for your neurosurgeon and the Physician treating your MS. That said, cutting nerve roots in Rhizotomy, like burning nerves to destroy them in Radio frequency Ablation, means the nerves no longer function.

  5. Theresa Mass

    I’ve had at least 8 rhitzos on both sides of my lower spine each and one on both sides of neck due to OA since 2012. I’ve had numerous unimaginable falls this year. Can it be related to procedures? Any way to improve situation?

    1. Regenexx Team

      Killing nerves which stabilize the spine isn’t a good idea. We’d need to examine you to see if the falls are likely related, or whether they are a symptom of something else. Let us know if you’d like to do that. Please see: https://regenexx.com/blog/never-proud-mris-show-holes-burned-patients-bodies/

  6. Melissa

    I had this procedure done 8 days ago. I’m in so much pain down my leg. It hurts to touch from my knee down and it’s a weird numb, tingling feeling. And it feels like it’s on fire. I feel like I have pinched nerves in my spine and muscle spasms. All of this on top of my pain I originally was getting treated. Is this normal? It’s pure agony!

    1. Regenexx Team

      Killing nerves and tissue is a bad idea. Please contact the Dr. that did the procedure as some of those issues warrant looking into.

      1. Melissa

        Its going on 7 months now and I still suffer in a lot of excruciating pain. The doctor has been trying different medications (gabapentin and lyrica) and nothing has helped as of yet. In the last 2 months, my right arm is tingling and numb…right to my fingertips. I’ve seen a neurologist and he suspects that I have sensory nerve damage. Has anyone heard of this side effect happening before, if so, how long did it last and what worked to relieve the pain? I’m feeling like there’s no hope at the end of my pain tunnel.

        1. Regenexx Team

          What area was treated with RFA?

  7. Lisa

    I have been getting this done for 3 maybe 4 yrs now.. Every 6 months.. I just had it done 2 days ago.. The iv wasn’t in my vain which left the anesthetics not working.. I was awake while they did the left side and it killed me.. I mentally and emotionally am way to scared to get it done again.. I dont know what to do at this point for my back

    1. Regenexx Team

      Hi Lisa,
      Because this procedure kills off important back stabilizers, there is a cumulative negative effect. Please see: https://regenexx.com/blog/multifidus-back-pain/ and https://regenexx.com/blog/multifidis-pain/ and https://regenexx.com/conditions-treated/spine/ To see if we can help, please submit the “Are You a Regenexx Candidate” form at the last link.

  8. Melissa

    My right side lower back was treated. It’s been 15 months now and I’m on long term disability. The doctor is still trying different medications to help with pain and nothing. The ‘tingling’ I had in my hands is now pain and stiffness. I had an appointment with the dr a couple of days ago and he said he doesn’t think this will ever go away. I’m devastated because how can I live the rest of my life in pain that is just getting worse?

  9. ronald letourneau

    I was injuried having this done. Do you know of any lawyer that would take a look at this. I’m in PA.

    1. Regenexx Team

      Hi Ronald,
      Unfortunately damage from RFA is not uncommon. But, no I’m sorry, we don’t.

  10. Robert T. Tillotson

    I had lower back lumbar rhizotomy left and right side early 2017. By the end of the year I can hardly walk completely upright. Now late 2019 not better probably worse. Never got pain relief for back condition either.
    Now guess not much can be done. I would never recommend anyone burn out nerves in your body.

  11. Ayisha M

    Post this discussion and delete first one please:
    I had a Rhizotomy on both the left and right sides of my lower back, and about 9 months after both procedures I am in more pain than before. I can’t sit for any longer than 20 minutes, can’t wear heels, can’t stand for more than 10 minutes without having to shift my weight to relieve than pain on either side, and lying down is a chore unless I have one of my three sons or husband around to pull me up. There was no talk of PT after the surgery and this was done as an outpatient. I am a healthy, and outgoing woman in my late 40’s, that is missing out on a so much. Never thought having this surgery would affect my husband’s and I “empty nest” life so much. I would never consider doing this again. (NOTE: I also had a ablation (same as an Rhizotomy) on the left side of my neck, and the results were amazing and I was pain free for about 1 full year. However, the pain is back, note this too was an outpatient procedure. I went to a surgeon who informed me that the pain may becoming for deep soft tissue damage, which my spine doctor never mentioned to me, even after follow-up. If you decide to do a Rhizotomy just know that these “procedures” are not cheap, they are costly due to the process. Ask all the questions that you can think of before agreeing to this process, read others posts and experiences. I know that we all heal differently, but just ASK QUESTIONS, and for those of you that this procedure has worked for…. I am so happy for you.

  12. Carol A. Morales

    My treatment started in January, 2020 and ended about 2 months ago. Since treatment, I have been plague with “clicking/clacking” noises in my head. They click when I walk, clicking mostly all day in the area that was treated (left). Anyone experiencing anything like this?

  13. Wolfgang Dahnert

    I would like to point out that the left side of the photo is also the left side of the Patient.

    1. Chris Centeno, MD Post author

      In an MRI axial image, the left side of the image is the patient’s right side.

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