NEUROLYSIS or nerve ablation procedures
I am often asked, “Doc, can’t you just cut a nerve to take away my pain?”
Unfortunately, it’s not quite that simple. Surgeons have certainly tried to do this, but often times with increased pain following the procedure. Nerves when cut beyond what is called the dorsal root ganglia (the brain of the nerve cell) will try to grow back. If you cut a nerve or destroy a nerve that is responsible for a large surface area of sensation on your body, that will obviously cause numbness in that area. This numbness can create confusion within the central nervous system and sometimes cause a syndrome called deafferentation pain. This is similar to the pain created following an amputation referred to as phantom pain. And of course if you cut a nerve that is responsible for the motor control of your muscles then you will have weakness or paralysis of that extremity. Also most often there are blood vessels that course near nerves, increasing potential risks of trying to destroy a nerve. So for these reasons (and the other typical procedural concerns such as infection risks, the pain of the procedure), cutting or destroying most nerves is not considered.
However, we have now established a few ablative pain interventions available for certain types of pain problems. This is primarily due to trial and error and then through further research studies. Areas I will cover in the upcoming blogs will include: Radiofrequency ablation(RFA) or heat lesions, Cryoablation, and Chemical ablation. I will discuss minimally invasive procedures that are commonly done by a physician, who has specialized in pain interventions. RFA lesions are the more commonly done neurolysis procedures and thus I will spend more time/blog posts discussing this technology. Stay ‘tuned’ for the upcoming posts on RFA(‘Radio’frequency Ablation) 🙂 Some pain humor 🙂