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facet joints

This Common Outpatient Procedure Could Be Your Solution to Low Back Pain

By: Vikram Arora, DO   December 14, 2018

Low back pain is frequently caused by the facet joints—these are the joints in the spine that allow your back to bend and twist. Facet joint pain could be the result of an injury, arthritis, or degeneration. (When you’re injured, you can be seen by an orthopedic specialist right away at our walk-in injury center.)

Fact joint pain can be treated by physiotherapy and injections, but if these methods are ineffective your physician may recommend an outpatient procedure called radiofrequency neurotomy.

What is lumbar radiofrequency neurotomy?

Lumbar radiofrequency neurotomy is a very common procedure for people with chronic low back pain. It uses heat generated by radio waves, delivered by needles inserted into the skin, to temporarily prevent the nerves that attach to the facet joints (called the lumbar medial branches) from sending pain signals. The heat lesion interrupts the pain signals that are transmitted from the joints, which ultimately results in reduced or eliminated back pain.

Additionally, radiofrequency neurotomy procedures can also be performed to the cervical, thoracic, and sacral regions of the back.

Who would need this procedure?

Any patient with chronic axial low back pain may benefit from this procedure. Axial pain refers to pain concentrated in the back, without radiating to the legs. It is important that a comprehensive medical history and examination is performed to determine whether or not this procedure is appropriate for you.

If your physician thinks you are a candidate for lumbar radiofrequency neurotomy, he or she will use a nerve block (or lumbar medial branch block), to determine whether the facet joints are truly the source of your pain. If the nerve block alleviates your pain, it’s a sign that radiofrequency neurotomy will be successful.

What happens during the procedure?

Lumbar radiofrequency neurotomy is a same-day procedure performed at an outpatient surgery center. The entire procedure will generally take 30-60 minutes, depending on the number of nerves being targeted.

The procedure itself is done with local anesthetic. General anesthesia is not required nor recommended for this procedure.

When do you start seeing results?

In most cases, patients will begin to see results within the first three weeks following the procedure. This is due to the fact that it takes time for the nerves to stop transmitting signals to and from the joint after they are lesioned. The duration of relief following the procedure can range from 6-14 months.

Other things to keep in mind

It is necessary that you have a skilled provider performing this procedure. It is very important that the radiofrequency needles are placed at the correct angles to ensure proper lesioning of the nerves. Patients should also remember that eventually the nerves will regenerate. The pain from the joints will return at that point. The good news is that lumbar radiofrequency neurotomy can be repeated to provide the same amount and duration of relief.

Dr. Vikram Arora is a physiatrist specializing in non-operative treatments for spine pain.

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spine, back pain, orthopedics