A Visual Guide to Radiofrequency Neurotomy for Facet and Sacroiliac Joint Pain

Facet joint pain may be caused by arthritis or spinal stenosis. If this is the case for you, a type of injection procedure called a radiofrequency neurotomy—or radiofrequency ablation—may be a treatment option to consider.

See Radiofrequency Neurotomy for Facet and Sacroiliac Joint Pain

Read on to learn more about how a radiofrequency neurotomy is done.

Lumbar Radiofrequency Neurotomy VideoFacet joint pain may be treated with radiofrequency neurotomy.
Lumbar Radiofrequency Neurotomy Video

Facet joint pain

Facet joints, shown here in purple, are located in the back of your spine, connecting the vertebrae at each level. They are small joints. Their function is to support your spine while allowing it to twist, bend, and flex. They function along with the disc and vertebrae as part of a 3-part joint complex.

See Facet Joint Disorders and Back Pain

Two small medial branch nerves, highlighted above in purple, are connected to each facet joint. These nerves carry pain signals from the facet joints to the brain.

See Anatomy Of Nerve Pain

The pain may be caused by a number of spinal conditions including:

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Radiofrequency neurotomy procedure

In this procedure, a heat lesion created on irritated nerves through radiofrequency neurotomy is designed to interrupt the signals from the medial branch nerves to the brain, eliminating the pain.

See Pain Signals to the Brain from the Spine

To begin the procedure, the patient lies face down on a table, giving the physician full access to the back of the lumbar spine.

See Lumbar Spine Anatomy and Pain

The physician will then numb the area around the nerves with an injection of local anesthetic.

Using X-ray guidance, called fluoroscopy, to visualize the area, the physician directs a special radiofrequency needle alongside the medial nerves.

Watch: Facet Joint Injection Procedure

The physician confirms that they have correctly targeted the nerve by passing a small amount of electrical current through the needle to the nerve. As the current passes through the needle, it should recreate the usual pain in your back and cause a muscle to twitch. Once the correct nerve is targeted, the nerves are numbed with a local anesthetic to minimize pain.

See Anatomy Of Nerve Pain

The tip of the needle is heated by the radiofrequency waves, creating a heat lesion on the nerve. This lesion will disrupt the nerve's ability to send pain signals to the brain.

As with many spinal injection procedures, radiofrequency neurotomy works better for some patients than for others. However, for many the procedure is often helpful in reducing a patient's pain enough to participate in a rehabilitation program.

Learn more:

Radiofrequency Ablation Procedure

Facet Joint Injection Procedure

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