Facet joint pain may be caused by arthritis or spinal stenosis. Our video walk-through can help you visualize how an injection procedure called a radiofrequency neurotomy—or radiofrequency ablation—may relieve your symptoms:

See Radiofrequency Ablation (RFA) for Facet and Sacroiliac Joint Pain

A trauma to your lower back is a less-common cause of facet joint pain.
Lumbar Radiofrequency Neurotomy Video

Video highlights

Facet joints (shown above in purple) are located in the back of your spine, and they connect your vertebrae at each level. These small joints support your spine while allowing it to twist, bend, and flex. Facet joints function 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 your facet joints to the brain.

See Cervical, Thoracic, and Lumbosacral Medial Branch Nerves


Causes of pain

The pain carried by your medical branch nerves may be caused by a number of spinal conditions, including:

Radiofrequency neurotomy procedure

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

See Pain Signals to the Brain from the Spine

To begin the procedure, you lie face down on a table; allowing your physician full access to the back of your lumbar spine.

See Lumbar Spine Anatomy and Pain

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

Using X-ray guidance (called fluoroscopy) to visualize the area, your physician will next direct a special radiofrequency needle alongside your medial nerves.

Your physician will confirm she or he has targeted the correct 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.

See Anatomy Of Nerve Pain

Once the correct nerve is targeted, your nerves will be numbed with a local anesthetic to minimize pain.

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

See Medial Branch Nerve Blocks

Radiofrequency neurotomy complications

As a a general rule, a radiofrequency neurotomy is considered a relatively safe procedure. But like any medical procedure, there are potential risks, including:

  • Permanent nerve damage
  • Infection
  • Allergic reaction
  • Skin numbness

Additionally, 3-5% of patients will experience a sunburn type pain that is quite troublesome and will last for several weeks.

See Radiofrequency Ablation (RFA) Side Effects and Risks

The good news is that there is no scientific evidence to support the claim that neurotomies place a patient at an increased risk for injury.

Learn more:

Radiofrequency Ablation (RFA): Procedure and Recovery

Cervical Facet Radiofrequency Neurotomy Video