Radiofrequency Ablation

One in six Americans suffers from back pain every day.1 Fortunately, there is a treatment option called radiofrequency ablation that can bring quick, long-lasting relief.2-7

Radiofrequency ablation or lesioning is a minimally invasive procedure that can provide lasting relief to those suffering from facet joint pain.7 In fact, clinical studies show that radiofrequency ablation significantly reduces pain severity and frequency for one to two years in the majority of patients.5,7 Radiofrequency ablation involves applying heat to certain nerve pathways to “shut off” the transmission of pain signals to the brain. It is performed on an outpatient basis. It has a high success rate5,7 and low complication rate.2,7,8

Signs and symptoms of facet joint pain include the following:

Lower Back Symptoms

  • Pain or tenderness in the lower back
  • Pain that increases with twisting at the waist or bending backward and extending the lower back
  • Pain that moves to the buttocks and hips or the back of the thighs—usually a deep, dull ache
  • Stiffness or difficulty with certain movements such as standing up straight or getting up out of a chair

Neck Symptoms

  • Difficulty rotating head
  • Neck pain
  • Headaches
  • Shoulder pain

Cause of facet joint pain

Facet joints are common sources of chronic back and neck pain.6,8 Each vertebral body in your spine has three main points of movement: the intervertebral disc and the two facet points. These facet points are small, stabilizing joints located on either side of each vertebra and consist of bony knobs coated with a slippery cartilage. As a disc thins with aging and from daily wear and tear, the space between two spinal vertebrae shrinks, eroding the cartilage and causing painful friction. Fractures, torn ligaments and disc problems can all cause abnormal movement and alignment, putting extra stress on the facet joints.

Benefits of radiofrequency ablation.

• Longer-lasting pain relief compared to steroid injections 8
• Low complication and morbidity rates 2,7,8
• Appreciable pain relief compared to surgery: nearly half of back pain sufferers are not helped by surgery9
• Greater range of motion2
• Lower use of analgesics2,5
• Improved quality of life2
• Short recovery time5

Resources

1. Boswell MV, Colson JD, Sehgal N, Dunbar EE, Epter R. A systematic review of therapeutic facet joint interventions in chronic spinal pain. Pain Physician 2007 Jan;10(1):229-53.
2. Nath S, Nath CA, Pettersson K. Percutaneous lumbar zygapophysial (facet) joint neurotomy using radiofrequency current, in the management of chronic low back pain. A randomized double-blind trial. Spine. 2008 May 20;33(12):1291-7; discussion 1298
3. Burnham RS, Yasui Y. An alternate method of radiofrequency neurotomy of the sacroiliac joint: a pilot study of the effect on pain, function, and satisfaction. Reg Anesth Pain Med. 2007 Jan-Feb;32(1):12-9.
4. Dreyfuss P, Halbrook B, Pauza K, Joshi A, McLarty J, Bogduk N. Efficacy and validity of radiofrequency neurotomy for chronic lumbar zygapophysial joint pain. Spine. 2000 May 15;25(10):1270-7.
5. Arora R. Radiofrequency neuroablation in chronic low back pain. Practical Pain Management. 2005 March;18-20
6. Bogduk N. Management of chronic low back pain. Med J Aust. 2004 Jan 19;180(2):79-83.
7. Jensen M, Brant-Zawadzki M, Obuchowski N, et al. Magnetic Resonance Imaging of the Lumbar Spine in People Without Back Pain. N Engl J Med 1994; 331: 69-116.
8. Boswell MV, Colson JD, Spillane WF. Therapeutic facet joint interventions in chronic spinal pain: a systematic review of effectiveness and complications. Pain Physician 2005 Jan;8(1):101-14
9. Sehgal N, Shah RV, McKenzie-Brown A, Everett CR. Diagnostic utility of facet (zygapophysial) joint injections in chronic spinal pain: a systematic review of evidence. Pain Physician 2005 Apr;8(2):211-24.
10. SpineUniverse.com. “Facet Rhizotomy.”Steven Richeimer, MD. www.spineuniverse.com/displayarticle.php/article200.html. Accessed October 13, 2008.
11. International Spine Intervention Society. Practice Guidelines for Spinal Diagnostic and Treatment Procedures. Percuteneous radiofrequency lumbar medial branch neurotomy. pp188-218.

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