CentraState - Healthy Directions

H e could never forget it. Even if he tried—a seemingly futile task—the pain in his lower back provided a constant reminder of the horrors of the near-fatal boat crash. Freehold resident Wendell Nanson, 57, says that in addition to severely damaging the vertebrae in his lower back, the accident nearly 25 years ago resulted in multiple injuries. Unfortunately, he says, his condition only deteriorated with time. Working as a contractor for the Port Authority of NY and NJ, Wendell's health had deteriorated so much he could not take care of the day-to-day operations of the business and had to start giving up his contracts. He returned to the farming sector, raising Black Angus beef cows and growing hay. However, these tasks proved to be impossible in April 2015, when his condition took a dramatic turn for the worse. "I had to be taken to the hospital by ambulance, because any movement was excruciating," Wendell says. "The pain was probably a 15 on a scale of one to 10, and I lost the use of both legs." He could stand, he says, but he couldn't walk. The ambulance took him to CentraState Medical Center—a happenstance, according to Wendell, that played a major role in his recovery. There, his orthopedist introduced him to Megad Ghattas, MD, a pain- management specialist board-certified in anesthesiology. Instead of only touting traditional pain-management techniques—medication, surgery and physical therapy—Dr. Ghattas offered Wendell another approach: radiofrequency ablation (RFA). With RFA, interventional pain specialists such as Dr. Ghattas deaden the nerves supplying the facet joints, which connect the vertebrae together. "When those joints become very arthritic and patients are unable to function, the only way to return them to their normal function is to deaden the nerves causing the pain," Dr. Ghattas says. The treatment typically takes six to eight weeks to complete and has been met with very favorable patient outcomes. For Wendell, RFA has been a game-changer. Dr. Ghattas performed RFA on the right side of Wendell's back first; one month later, the left side was ablated. "Honestly, I haven't felt this good in 10 years," Wendell says, pointing out that he no longer has to take pain medication to get him through the day and perform his farming tasks. He is 100 percent back in business, he says. "Just being able to get out on the farm without being in pain is phenomenal," Wendell says. "My quality of life has completely turned around." Yes, he still has to take it easy at times, but he says his pain is nearly gone. "Now it's my knee," Wendell says. "Go figure." For more information about pain management services at CentraState, call 866-CENTRA7 (866-236-8727). HD Megad Ghattas, MD, board-certified anesthesiologist How does RFA work? Radiofrequency ablation (RFA) is a process that ends chronic pain by disabling the nerves responsible for sending pain signals to the brain. Radiofrequency energy is heat produced by a generator in order to precisely target the destruction of specific nerves carrying unwanted nerve impulses. This treatment works by using radiofrequency energy to heat and destroy the nerves, called medial branch nerves, responsible for sending ongoing pain signals to the brain. It is often used to treat pain in the facet joints (spinal joints) associated with arthritis. How is the procedure performed? This procedure is performed by a pain management physician specialist. The doctor, using X-ray or fluoroscopy (an X-ray where you can see internal structures in motion), kills the nerves sending pain messages. After treatment, relief from the chronic pain is expected to last anywhere from six to 12 months or more, based upon the severity of the original condition. The main side effect of RFA is some swelling and bruising at the site of the treatment, but this generally goes away after a few days. What types of chronic pain are recommended for this treatment? RFA is most commonly used to treat chronic pain as a result of arthritis, chronic back or neck pain associated with whiplash, and other neck injuries and chronic pain after spinal surgery. What patients might be suitable for this treatment? In some cases, prior attempts at alleviating pain with nerve blocks or steroid injections provide important diagnostic information in order to increase the effectiveness of ablation procedures. Patients are most likely to be considered for the procedure if they have already undergone epidural steroid injections, facet joint injections or sympathetic nerve blocks and not achieved acceptable pain relief. Radiofrequency ablation is a more involved interventional procedure than a steroid injection or a nerve block. Conversely, it also offers longer-term results. More than 70 percent of patients treated with RFA experience pain relief. Most importantly, there are several proven therapeutic solutions to back pain besides medication. Consult with a board-certified, pain management physician to discuss the solution that will finally put an end to your chronic pain. process that ends chronic pain by disabling the nerves How does RFA work? www.centrastate.com Winter 2016 5

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