Radiofrequency neuroablation for facet joint pain is like turning up the volume on pain relief.
That’s the downside of a conservative approach: There’s an element of individual trial and error in treatments – and a need for patient patience during the process.
First, some facts about facet joints
- The facet joints are the joints in your spine that enable you to bend and twist.
- Nerves exit your spinal cord through these joints on their way to other parts of your body.
- Healthy facet joints have cartilage, which allows your vertebrae to move smoothly against each other without grinding.
- Acute episodes of lumbar and cervical facet joint pain are typically intermittent and generally unpredictable. They can occur a few times per month or per year. In the lumbar case, sitting and riding in the car are worse.
- Most patients will have a persisting point tenderness overlying the inflamed facet joints and some degree of loss in the spinal muscle flexibility.
- Typically, there will be more discomfort leaning backward.
- Low back pain from the facet joints often radiates down into the buttocks and down the back of the upper leg – typically not past the knee or in the front of the leg or into the foot as a herniated disc might cause. Similarly, cervical facet joint problems may radiate pain locally or into the shoulders or upper back, but rarely in the front or down an arm or into the fingers as a herniated disc might.
So when a patient presents with severe neck, back or lower back pain, or radiating pain to specific areas, and facet joint involvement is diagnosed, the medical practitioners at Pain Stop North Phoenix with begin with less invasive procedures such as trigger point injections, trigger point massage and stretching.
However, if we’re not getting good results, then we turn up the volume. We don’t just jump to radiofrequency neuroablation – and it shouldn’t be recommended as the first line of pain defense. Even for those patients who have a higher level of pain, there’s still a process that needs to be followed.
What is radiofrequency neuroablation?
It sounds really invasive – but it isn’t. Put simply, heat is used to silence a nerve.
A diagnostic medial branch block nerve injection is given. If the pain ceases, that feedback tells us we’re on the right track. But just to make sure, we repeat the medial branch block nerve injection about two weeks later, as the effects of the first are starting to wear off, looking for the same result.
These two tests ensure radiofrequency neuroablation is the right procedure. Radiofrequency neuroablation is performed while the patient is under “conscious sedation” or in a twilight state. He or she is not fully under, but will not feel any pain, and can watch it being done.
The doctor inserts a small needle into the painful area, which is then stimulated with a microelectrode inserted through that same needle to help determine the correct placement of the electrode for the treatment. Once confirmed, a small radiofrequency current is sent to the tissue, causing it to heat up – and quieting the nerve.
This proven safe and effective treatment can provide facet joint pain relief for 6-12 months, and in some cases, years. The patient is usually ready to leave within 20 minutes or so – but we suggest they do not drive because they have been given anesthesia. In total, the patient is in and out within 45 minutes – about the time spent in a dentist’s office to have a cavity filled.
Most people feel improvement right away. However, sometimes there’s minor discomfort for a day or two.
Rest assured, at Pain Stop North Phoenix, we will first become thoroughly acquainted with you and your pain and map out the most prudent path. This approach speaks volumes to our patients.
By Erin Waychoff, DC
Owner of Pain Stop North Phoenix