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.
Read on to learn more about how a radiofrequency neurotomy is done.
Watch: 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.
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.
The pain may be caused by a number of spinal conditions including:
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.
To begin the procedure, the patient lies face down on a table, giving the physician full access to the back of the lumbar spine.
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.
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.
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.