L5 S1 pain/RFA

[rod99]

Male, 47 years old, high 4.5 player, can play singles or doubles.

about 2.5 months ago i played a couple singles matches over a weekend and started noticing some discomfort in my right glute area. there was never a "oh crap, i just pulled something" moment. i took a week off and played and i started feeling it on the lower right side of my back. i got an x-ray and MRI and my spine looks fine and no disc issues. there is some normal age related arthritis and a small tear in the l5 s1 area. definitely no surgery needed. the doctor believes that it is an irritated nerve in the L5 S1 joint. i feel mostly fine doing day to day stuff but if i play any kind of tennis (even just hitting for 30 minutes) then the discomfort gets worse and takes a good week to get back to where i was before hitting.

i have had 2 cortisone injections in the area which helps initially but playing tennis reaggravates it. i also do about an hour of physical therapy exercises daily. i have never had back issues before but i am extremely tight all over which the PT is supposed to help with to take pressure off my back. no pain or numbness running down my leg.

my doctor is approving me for radio frequency ablation (RFA) to temporarily kill the nerve and hope that when it grows back then it won't be irritated. has anyone had this done and returned to tennis at the same level you were before the procedure?

easily the most frustrating injury i have ever had.

 

[EggSalad]

Is the pain always in your glute?

I’m 47 and back in 2023, I herniated my L5/S1. I had a Microdiscectomy in 2023 and am back playing as well or better than before the injury.

If the pain is only in your glute, you might ask about piriformis syndrome. It’s not very common but it is in the glute and can aggravate the sciatic nerve.

 

[rod99]

Is the pain always in your glute?

I’m 47 and back in 2023, I herniated my L5/S1. I had a Microdiscectomy in 2023 and am back playing as well or better than before the injury.

If the pain is only in your glute, you might ask about piriformis syndrome. It’s not very common but it is in the glute and can aggravate the sciatic nerve.

it initially started in the glute but it then started in the lower right side of my back. no real glute pain anymore. it's all in the L5 S1 area of my lower back.

 

[Danapoint]

I've had 3 RFA's over the past 2.5 years. The first one was like magic---no pain for 6-7 months. Returned to same level playing as before back pain started. I don't see any harm in giving it a try, it's minimally invasive and you'll know pretty quickly if it works.
Unfortunately, I'm 20 yrs older than you ---still play at 4.5 level when pain free. But arthritis is not going away.
Keep your core strong, that does help. Good luck.

 

[LuckyR]

Is the pain always in your glute?

I’m 47 and back in 2023, I herniated my L5/S1. I had a Microdiscectomy in 2023 and am back playing as well or better than before the injury.

If the pain is only in your glute, you might ask about piriformis syndrome. It’s not very common but it is in the glute and can aggravate the sciatic nerve.

I had piriformis syndrome after doing a racewalking relay event over 48 hours about 15 years ago. Ended up needing a cane for 11 weeks. It slowly got better with rest (over the 11 weeks) then I got 100% cured with a blast dose of oral steroids.

Good luck and don't play around with it. Take it seriously.

 

[rod99]

I've had 3 RFA's over the past 2.5 years. The first one was like magic---no pain for 6-7 months. Returned to same level playing as before back pain started. I don't see any harm in giving it a try, it's minimally invasive and you'll know pretty quickly if it works.
Unfortunately, I'm 20 yrs older than you ---still play at 4.5 level when pain free. But arthritis is not going away.
Keep your core strong, that does help. Good luck.

how long after the procedure are you able to play? dr mentioned waiting a week.

 

[Danapoint]

I was able to play after a week. But didn't go full speed at first. 2nd week was back to full speed.