This is a YouTube video titled "Treating Chronic Back Pain" containing a detailed monologue from November 21, 2020, explaining the anatomy of the spine, common causes of facet joint arthritis, and various anesthesia-based treatments such as nerve blocks and radiofrequency ablation, including their effects and side effects on spinal muscles.
In the back, we have the spine is made up of a disc and the vertebrae in the front, and then two little facet joints in the back. So force is moving through there. And think of half of the force moving through the front of the spine and then half the force moving through the back of the spine. It's real common for people to get arthritis in the facet joints. which I have terribly, which you had. And so then the my people, I can talk about this, the anesthesia pain people of the world, our philosophical approach has always been to go, uh-oh, somebody's got pain. If they've got pain in that facet joint, let's see if we couldn't stick a needle in and numb that joint up and make it not hurt. So it turns out, sure enough, there's a nerve called the medial branch. And if you stick in a nerve and needle and numb that up, next thing you know the pain goes away. So then let's say you do that and you go, God, this poor guy's facet joint is causing pain. Then the anesthesia world, what we say is let's try to turn the inflammation off in that joint. And so then they probably went in and put some steroids in there. But then the other thing they will do if that starts to fail is they'll say, let's just kill that nerve. If they kill that nerve, like when I had radio frequency ablation, that's the radio frequency ablation, so they stick a needle in and then they turn the temperature way up hot and get it super hot and the nerve kind of dies. Turns out it doesn't totally die, but it kind of dies for a year. So then all of a sudden the pain goes away, but now for the next year you're walking around and that nerve that is controlling how force goes through the back part is not working because it's off. And so then that can't do its job and it leads there to be a little anterior sliding that pinches the nerves coming out. But then the other thing that happens is there's no electrical supply, which means there's no electrical supply to the deep spinal muscles that we call the paraspinal muscles that are kind of like the cables on the Golden Gate Bridge that need to hold everything together. And so what people get, the way that you know if they did a good job on radiofrequency ablation is that you end up getting something called fat atrophy of your spine muscles. That's what I got. That's what you got. That's what I got. They did a good job, but they made my muscles weak.
