Nonsurgical relief for neck, back pain
“I’d been dealing with neck and lower-back pain for a good ten years,” relates Mark Schmidt, 68, a retired health care human resources professional. Arthritis was the culprit.
“My neck and shoulders were really a problem,” the Palm Springs resident says. “I’d be okay when I first woke up, but the pain would get worse as the day went on. It got pretty intense.”
Schmidt started seeing a chiropractor regularly, but the pain persisted. He did stretching exercises. In late 2021, he saw a rheumatologist, who prescribed muscle relaxants. “But they made me sleepy and foggy, so I couldn’t take them during the day,” he says.
“Then, in the spring of 2022, I remembered seeing a sign for a pain management clinic near where I get my lab work done,” he recalls. “No one, even my primary care doctor, had ever suggested this to me. But I decided to check it out.”
Schmidt made an appointment with Kevin Wong, DO, a Board Certified Anesthesiologist with fellowship training in pain medicine who is part of Eisenhower Desert Orthopedic Center — Pain Management.
“He was phenomenal,” Schmidt says of his initial encounter with Dr. Wong. “He sat and listened to my clinical history, then did some testing and assessed my movement and range of motion.”
This thorough evaluation revealed that Schmidt had what’s called facet-mediated joint pain. The facet joints are located in the back of the spine, with two (one on each side) at every vertebral level. Nerve roots pass through these joints, going from the spinal cord to the arms, legs and other parts of the body. These joints also enable the spine to turn and bend, and they provide stability, preventing the back from bending or twisting too far.
“Mr. Schmidt’s neck pain occurred when he turned his head or looked up, and it extended into his shoulder,” Dr. Wong explains, noting there was no numbness, tingling, weakness or shooting pain down the arm, symptoms often associated with spinal cord compression. “This told me that facet joint movement was creating the pain.”
It also suggested that Schmidt was a good candidate for radiofrequency (RF) ablation.
“RF ablation is a technique of using thermal energy — heat — to destroy a nerve and reduce pain anywhere along the spine,” Dr. Wong says. “It’s used for symptomatic relief of arthritic pain that originates from a facet joint in the back.
“It’s a minimally invasive procedure in which we insert a needle, then the tip of the needle generates heat that destroys the nerve in the joint that’s sending the pain signal to the brain,” he continues.
“It’s a very low-risk procedure,” he stresses. “There’s no incision and the needle we insert is nowhere near the spinal cord. The nerve we destroy is a tiny sensory nerve the size of a hair strand. All it does is transmit a pain signal; it doesn’t affect any motor function like walking, standing or arm movement.”
Plus, Dr. Wong says, the outpatient procedure takes only about fifteen minutes and is performed under sedation to ensure patient comfort. Patients can resume their regular activities the next day.
Notably, the success rate for this procedure is upwards of 80%, with patients experiencing pain relief for up to two years post-procedure.
“We anticipate a minimum of six months of pain relief because it takes at least that long for the nerve to grow back,” Dr. Wong says. The procedure can be repeated up to twice a year (every six months).
What’s more, patients can know in advance if RF ablation will help relieve their pain.
“Before we perform the ablation, we perform two nerve blocks to test the nerve,” Dr. Wong explains. With a nerve block, numbing medication is injected next the nerve to block the pain signal. “If the pain is significantly reduced, we know we’ve got the location correct and ablation is actually going to help the patient.”
Schmidt’s “test runs” alleviated his pain for three to four hours, indicating that RF ablation would be successful longer term. He underwent the procedure in June 2022.
“It took about ten weeks, but the pain did subside,” he says. “If I overdo it, I’ll feel a little neck pain, but it’s nothing like it was. It’s fantastic!”
Why the delay between procedure and pain relief?
“While some patients feel immediate pain relief once the nerve is destroyed, in others it can take a few weeks to see the full benefit,” Dr. Wong says. “That’s because the ablation can cause a residual burn sensation or ache around the soft tissue in the treated area and take a while to resolve.”
Schmidt was so enthusiastic about the resolution of his neck pain that he returned to Dr. Wong to see if RF ablation could help with his low back pain.
“I was having to limit my activities more and more due to back pain,” he says. “Then, in November of 2022, I fell getting up in the middle of the night to get water. The fall triggered such severe back pain, I could barely walk. I tried physical therapy and continued with my chiropractor, but the pain was so debilitating that I didn’t really want to do anything. It was kind of a lousy way to live.”
“Mr. Schmidt’s physical exam confirmed that he was suffering from chronic axial low back pain related to lumbar facet mediated joint pain,” Dr. Wong says. “So we did the same thing: he went through two test nerve blocks, both of which gave him at least eighty percent pain reduction. Then the ablation gave him close to 95% pain reduction.
“It’s been more than a year now, and his quality of life has significantly improved,” he adds.
Schmidt agrees, noting that it took only about six weeks for the full effects of his lumbar RF ablation to kick in.
“I’m feeling great now,” he says. “I feel like I’m back to being a normal person. Sure, I have some pain if I overdo or stretch too much, but it’s nothing like it used to be. I do 8,000 to 10,000 steps a day; my husband and I walk every morning.
“I attribute it all to Dr. Wong,” Schmidt continues. “I’m a real cheerleader of him and feel very fortunate that I found this resource and it really worked for me. I always thought I could end up in surgery, so I kind of ignored my situation because I didn’t want to go down that road.
“But this is a great alternative path,” he adds. “I hope more people become aware of and utilize these services.”
For more information or to contact Eisenhower Desert Orthopedic Center, call 760.568.2684, or visit EisenhowerHealth.org/EDOC.
