By Jonathan Tran, MD

When we have a patient with lower back pain, in order to decide between ablation or nerve stimulation for treatment, we use a combination of patient history, imaging findings and a physical exam to help us determine where the pain generator is. If we find that the pain is arising from the disc itself or vertebral endplates, we can use ablation.

If we see significant facet arthritis on imaging and the pain is worse with bending backwards for example, we might consider ablation of the nerves that send signals from the arthritis in the back. This is also known as burning the nerves. In this case, some patients  may experience discomfort for several days post procedure. This post-ablation neuritis often subsides.

Unfortunately, with repeated radiofrequency ablation for facet arthritis, we’ve seen a weakening of the muscles of the low back.

There’s now a newer procedure we offering called Reactiv8, in which we stimulate the nerves to the weakened muscles of the lumbar spine. It allows use to activate and strengthen these muscles that are otherwise difficult to voluntarily contract. Overtime, we see increased lumbar stabilization and reduced low back pain.

We also have different types of spinal and peripheral nerve stimulation in addition to ablative procedures for neck and shoulder pain, knee pain, ankle and hip pain. Each patient is different with different medical problems and we tailor the treatment to the patient. If a someone is debating surgery or trying to postpone surgery as long as possible, our goal is to help them regain their quality of life with the most minimally invasive treatment available. This might also include injection-based treatment, physical therapy, or medication management, mostly non-opiate as our goal is to minimize the use of narcotic therapy.

Quoc Jonathan Tran, MD is a fellowship-trained interventional pain management specialist who practices with OrthoAlabama Spine & Sports.