Radiofrequency Ablation (RFA) for severe back pain

Terry Hendrix had problems with her cervical spine for decades. She saw neurologists, chiropractors, and a pain management specialist who administered cortisone in­jections. After she married in September 2020, she be­gan having even more severe pain in her lower back.

“I couldn’t stand up without being in excruciat­ing pain. I couldn’t sleep. I was totally miserable,” Hendrix recalls.

Her neurologist Kim Monday, MD, an associate professor at McGovern Medical School at UTHealth Houston, referred her to interventional pain management specialist Nadya Dhanani, MD, an assistant professor in the Vivian L. Smith Department of Neurosurgery who is dual board certified in anesthesiology and pain management.

“By the time I saw Dr. Dhanani, I could hardly walk,” Hendrix says. “She was so thorough in her examina­tion. I told her about my neck but by then, my lower back was the main issue. I couldn’t sit, stand, or walk.”

In November 2022, Dhanani did a diagnostic medi­al nerve branch block in Hendrix’s lumbar spine to understand the role her arthritis was playing in her lower back pain. “We use a long-acting local anes­thetic that temporarily blocks the nerve signals to the brain to determine if the patient is a candidate for ra­diofrequency ablation (RFA),” Dhanani says. “Those who show an 80% improvement in two sets of nerve blocks are candidates for ablation.”

After her first nerve block, Hendrix felt relief almost immediately. “Dr. Dhanani told me to go home and follow my normal routine, but I felt so good I weed-eated the garden. Then I cooked dinner and still had no pain. The pain didn’t start coming back until around 9 p.m.”

A week later Hendrix underwent her second nerve block and was pain-free for four hours, qualifying her as a candidate for RFA. Dhanani performed the noninvasive procedure in December, using fluorosco­py to direct needles toward the medial branch nerves. Once the needle tips were placed, she inserted an ac­tive electrode and carefully passed a small amount of electrical current to the target nerves, with Hendrix under conscious sedation.

“By the time I got home, I had no pain,” she says. “I slept all night and told my husband I had never been so free of pain. I was ecstatic!”

In early 2023, they turned their focus to her cervical pain. After completing two sets of diagnostic medial branch nerve blocks in her neck, Hendrix underwent the RFA procedure in March.

“My little finger and ring finger were numb constant­ly, and my neck problems were causing me to drop things,” says Hendrix, 67. “Within two weeks I had my strength back in my hand with no tingling. When I drove, I couldn’t turn my neck because of the pain so I adjusted my mirrors to compensate. One day I was driving and realized that I had turned my neck without pain. And I have suffered with this for de­cades! Dr. Dhanani is an amazing lady and an awe­some doctor.”

Dhanani considers Hendrix an ideal patient. “She is a very active woman who became extremely limited in her ability to move,” she says. “Now she’s doing really well. Every six to 12 months we can repeat the procedure as the nerves grow back, and we can do it indefinitely. Some of my patients have been doing RFA with me for the entirety of my nine-year prac­tice. There is no downtime, very little risk, and an immense improvement in their quality of life.”