An Effective Lesion Plan

Radiofrequency ablation eradicates chronic back pain

Henry Towery opted to remain close to home for his undergraduate education. He earned a bachelor’s degree from Murray State University in his Kentucky hometown. To pursue his graduate degrees, however, he headed beyond the bluegrass to institutions farther south.

“When I finished my undergraduate degree, I decided to earn an MBA and enrolled in Louisiana State University in Baton Rouge,” recounts Henry, 85. “After that, I went to Florida State University in Tallahassee and earned a PhD in marketing.

“I was a university professor for more than 30 years. I taught in the College of Business at the University of South Florida in Tampa. Before that, I taught marketing at Florida State. In the latter years of my career, I taught mostly international marketing, which has been a very hot topic over the past 20 or 30 years.”

When Henry first arrived in Tampa, USF was relatively new. But he saw the university’s potential and became an integral part of its expansion and prosperity.

“The school was growing fast, so it was a great place to be,” Henry remembers. “It also looked like it was going to be a good school, which it turned out to be. Today, it’s a huge university.”

Henry retired from his position as a professor 27 years ago. He says he’s enjoyed “every bit” of retirement, but debilitating low back pain has long threatened his idyllic lifestyle.

“I’ve had problems with my back for probably 50 years,” Henry laments. “The condition caused significant pain on and off. The pain was very sharp and affected my ability to walk. Sometimes, the pain was a 10 on a scale of one to 10.”

Henry says the cause of the pain was damaged discs due to arthritis.

“When the pain was at its worst, I didn’t feel like doing anything other than sitting around and trying to get as comfortable as possible, so it stopped me from doing many of the things I enjoyed, including golfing, gardening and lawn work. It put a real damper on my physical activities.”

For years, the only thing that gave Henry any relief was epidural injections, which direct pain medication into the space around the spinal cord.

“I’ve had numerous epidurals, but the relief they provided was only temporary,” Henry notes. “I never knew when the pain was going to return. I rejected surgery because the success rate for my problem wasn’t very good.”

Henry’s pain was so great that he and his wife sold their summer home in North Carolina because he could no longer help maintain it. Following the sale, they moved to a high-rise condominium in St. Petersburg. That proved quite fortuitous because that’s where Henry met Lora L. Brown, MD, a fellowship-trained interventional pain specialist at TruWell Health. 

“Dr. Brown and her parents used to live in the same building as us,” Henry recalls. “Dr. Brown’s dad helped convince me to visit her because he had the same problem, and she treated him successfully. So, the next time my back flared up, I made an appointment with Dr. Brown.” 

Facet Joint Arthritis

Dr. Brown conducted a thorough examination during which she determined that Henry’s pain was likely related to the facet joints of his lumbosacral spine, near the small of the back and the back part of the pelvis between the hips. 

To confirm the diagnosis, she performed a selective nerve block to localize the pain to the facet joints.

“During the procedure, we inject numbing medication on the medial branch nerve, which provides sensation to the facet joints,” the doctor details. “If the pain goes away, we know it is coming from those joints because the nerve supplying them is the only thing we numb.”

The facet joints connect the vertebrae. There is one on each side of the posterior aspect, or rear, of each vertebra. They allow for spinal mobility and
range of motion.

“The reason so many people have low back pain is because there’s significant range of motion in the lower spine,” Dr. Brown informs. “People can bend, twist, side bend and pivot due to the facet joints. But where there’s lots of motion, there’s an increased risk for wear and tear. As a result, the facet joints often become arthritic and painful. 

“That was the case with Mr. Towery. The treatment we chose to ease the pain of his arthritic facet joints was
radiofrequency ablation, or RFA.”

During Henry’s RFA, Dr. Brown used x-ray guidance to place a specialized probe over the medial branch nerve. The probe was connected to a machine that delivers radiofrequency energy that heats the tip of the probe.

“The heat generated by the radio-
frequency energy creates a lesion, or thermal burn, on the nerve,” Dr. Brown describes. “That lesion stops the pain signals from traveling from the facet joints to the spine and up to the brain, so the patient feels no pain.”

Dr. Brown stresses that RFA for facet joint arthritis is targeted to the medial branch nerve, which supplies only the facet joints. The discs, muscles and other structures in the spine are not disrupted. 

“When we ablate the medial branch nerve, the strength, support, stability and function of the spine are not affected in any way,” the doctor maintains. “RFA takes the pain away. That’s it. However, the nerve sheath is left intact, so the nerve does regenerate over time.”

Older forms of RFA technology created relatively small lesions that allowed patients to experience between six and 12 months of pain relief. Dr. Brown uses a more advanced technology that provides more extensive relief.

“The latest technology includes multiprong probes that create larger lesions,” Dr. Brown informs. “The larger the lesion, the longer it takes for the nerve to regenerate. As a result, our patients receive no less than a year and typically closer to two years of relief.”

“I Have Zero Pain”

Henry’s RFA was performed in summer 2022. He was pleasantly surprised by how quickly the procedure affected his back pain. 

“Almost immediately I felt results,” he enthuses. “The pain started to subside, and each day it got a little better. Today, I have zero pain, and it’s been that way for some time. I wear a back brace for support, use a cane for balance when I walk and don’t take any chances, but there’s no pain in my back.

“Dr. Brown told me I should get a year to a year and a half without the pain returning. And if it does, she can do the procedure again. So, it’s a good possibility I’ll have pain relief for some time.”

Henry is not only pleased with the results of the procedure, he’s also pleased with the doctor and her staff.

“Dr. Brown is very professional and knowledgeable about pain management,” he raves. “She explained everything to me so I could understand. Her staff is also very professional and competent. And the facilities at TruWell Health are impressive. I highly recommend them.” 

© FHCN article by Patti DiPanfilo. Henry’s photo courtesy of Henry Towery. RFA graphic courtesy of
Cleveland Clinic.

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    • TruWell Health

      TruWell Health is located in a professional medical building in downtown St. Petersburg. There is free parking and free valet service. Our office is elegant, warm, comfortable and modern, and we utilize the latest technology... Read More

    • Lora L. Brown, MD

      Lora L. Brown, MD, is certified by the American Board of Anesthesiology and American Board of Pain Medicine. She is also a fellow of the American Board of Interventional Pain Physicians. Dr. Brown earned her bachelor’s degree cum laude from th... Read More