Medial Branch Facet Injections and Radiofrequency Ablation – Another Option for Pain Control

Medial Branch Facet Injections and Radiofrequency Ablation -Another Option for Pain Control

For certain people, the source of back pain is the irritation associated with cartilage wear in the facet joints of the spine.  This wear and tear can cause pain that comes from the facets themselves, as the bones wear on each other, or the nerves from that particular facet joint to excite,  and cause pain.

The typical pain is a back pain,  that localizes to the lower back,  and buttocks. Based on testing such as MRI’s or even CT scans,   the degeneration of those joints can be identified.  As discussed many times in my previous blogs,  the findings on MRI’s or CT scans however,  may not correlate to your spine pain,  as there can still be many sources of neck and back pain.   These studies must be considered with the physical exam findings.  If the pain,  the physical exam findings, and the diagnostic studies match a particular pattern,  you can go to the next step,  which is a facet injection or a medial branch facet block.

Often, injections to the affected lumbar facet joints with steroid or a combination of lidocaine and steroid may give relief.  Sometimes in the spine,  any injection treatments may be just a process of elimination,  and any benefit may be a short term relief associated with the cortisone injected into the body.

If there is good relief of pain from the Facet Joint Injections,  then the physician may have identified the source of the pain, which is usually the degeneration of the facet joints of the lower back .  If there is reproducible pain relief with these injections,  there is a potential for longer term relief by stopping the pain nerve signals from that facet joint.

The nerve  from the facet joint usually follows a specific route.  If the messages of pain from that nerve can be interrupted, it can have a  much longer pain relief effect.  This can be accomplished by using a concentration of energy directly to the nerve root, after it is identified, thereby “turning off” the nerve to the facet joint. This procedure is called RADIO FREQUENCY ABLATION. It’s effects are almost immediate and last approximately 9 months to a year until the nerve repairs itself. It must be performed by a qualified physician under fluroscopy (x-ray) and is a good temporary pain relief measure instead of addicting pain medications.

Remember, it does not fix the problem but does help relieve the symptoms. While not all patients are candidates for this procedure,  it has been very helpful for the properly selected person.  Please consider a consultation to see if you are a candidate for the procedure. Check out the associated video for more information!

Citations

  • Grandhi RK, Kaye AD, Abd-Elsayed A. Systematic Review of Radiofrequency Ablation and Pulsed Radiofrequency for Management of Cervicogenic Headaches. Curr Pain Headache Rep. 2018 Feb 23;22(3):18. PubMed PMID: 29476360