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:
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.
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.
Causes of pain
The pain carried by your medical branch nerves may be caused by a number of spinal conditions, including:
- Osteoarthritis of the spine
- Spinal stenosis
- Trauma to your back (from a car accident or other injury)
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.
To begin the procedure, you lie face down on a table; allowing your physician full access to the back of your lumbar spine.
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.
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.
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
- 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.
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.