But Sunday’s was not an easy victory. The tennis player explained that he had to play almost the entire tournament, including the final against the Norwegian Casper Ruud, with the sensitive nerve in his left foot anesthetized.
It was the only way to alleviate the pain of the chronic injury that was diagnosed when he was only 19 years old (coinciding with the first time he won on the clay of Philippe-Chatrier) and that only 24 days before the final forced him to to retire, lame, from the Rome Tournament.
The ailment responds to the name of , a degenerative disease in the scaphoid bone that produces intense pain.
Also, it’s a disease very difficult to diagnose (It is only perceived through a specific X-ray) and it is normal that when it is discovered it is already in a very advanced state. Especially since it develops during childhood but the symptoms do not usually appear until adulthood (the average patient is around 50 years of age).
how can it be treated
The usual treatment, if it has been diagnosed early, is a combination of insoles and physiotherapy, although infiltrations can also be carried out in the affected area.
But Nadal is not an ordinary person, and the work that he is forced to do to his foot with the hours of daily training and tournaments, means that the usual treatment falls short and ends up losing its effectiveness.
So, since the state of his foot has reached its limit, and the situation cannot be prolonged over time, his medical team has decided to apply a “totally innovative” therapy to Rafa, as the Dr. Ian MacVeighhead of the , since it has never been applied in this ailment.
This is how Rafa Nadal himself has detailed it:
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“We are going to do a treatment that consists of an intervention in the two nerves. This is something that has worked well for me and that has already taken away my pain in the past. They are injections with pulsating radiofrequency that could help me reduce the sensation that I have in the foot. Let’s see if with this treatment we can leave the nerve half asleep”.
That pulsed radio frequencyor throbbing, is a technique performed by anesthetists to treat various types of chronic pain.
It is generally used for other pathologies such as Arnold’s neuralgia (condition that causes pain in the occipital nerve -back of the head-) or with herniated discs in the spine, but our specialist has never seen it used for this ailment.
“The pain can go away for about six months”
What is pulsed radiofrequency?
“Inserting an electrode into the point of pain (one or several nerves) that applies radio waves at a certain frequency to create a magnetic and electric field in the nerve and all peripheral tissues, producing neuromodulation,” says the specialist. Ian McVeigh.
A neuromodulation prevents that affected nerve from triggering “pain signals” or at least makes them “perceived with less intensity”.
The main difference between the conventional radio frequency and the one struck is that the latter uses a temperature of 42 ºC (compared to 80-90ºC for the traditional one).
It is also important that it is not neurodestructive, that is, it does not destroy the affected nerves but rather modulates them to reduce the sensation of pain.
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“The goal is for the pain signal to be less.”
Pulsed Radiofrequency: How is it done?
Dr. Macveigh points out that it has the virtue of being a very minimally invasive technique, although it also has the problem that “long-lasting effects are not achieved over time.”
How long can they last?
“The answer is very variable, since There are people who can go six months without hardly feeling pain while to others it may be of no use.
If we stick to the statistics that are used for the use of pulsed radiofrequency in other ailments, we could say that the effectiveness rate is between 70-80%.
But for this specific case it cannot be predicted in advance if it will be an effective treatment. “It’s trial and error,” stresses the specialist. “Nothing to lose”.
Pulsed radiofrequency is performed in the operating room, under sterile conditions, and is an outpatient technique (does not require hospital admission).
The estimated duration of this treatment is about 10 minutes.
And if it goes well, it can be repeated.
If the treatment response is positive, the pulsed radiofrequency can be repeated as many times as the patient wishes
Of course, the improvement is not noticeable until “after about ten days” and while it is recommended to rest.
Does it have side effects?
No. It has no consequences, since there is no thermal injury to the affected nerve, but rather it is only “modulated” to try to reduce the pain it produces in the patient.
In other ailments it is a common procedure to try to avoid the surgery. Something like the last option in the event that the discomfort and pain do not improve.
But as our specialist, Ian Macveigh, has said, No one is known to have used this technique for an ailment like Rafa’s, although the fact that his team recommends it does raise hopes.
Because what is clear is that Rafa is not willing to continue competing with an anesthetized foot, but he also does not consider facing an operation now as a possibility that would mean retiring from professional sport for at least six months.
As he himself explains:
“I would have to talk about that with myself, calmly, because it would be a life decision, to know if it is worth spending half a year without being sure of anything. I would have to understand things better to make that decision that I am not prepared to make now. Life is more important than another title. My career has been my…