What is radiofrequency facet denervation?

Facet joints connect each vertebra to the one above and below it. They are a common source of back and neck pain if the nerves near the joint become damaged due to age, overuse, or arthritis. Radiofrequency facet denervation uses radio waves to burn and destroy the nerves causing pain. An outpatient procedure, it is performed under fluoroscopy (x-ray guidance). You will likely receive a mild sedative to remain calm and comfortable during the procedure. After the sedative is administered, your back will be cleaned and the site will be numbed with local anesthetic (you might experience a twinge of pain at this time). A needle will be inserted near the site of the pain under x-ray. Your provider will stimulate the nerve to recreate the pain and ensure the correct nerve is targeted. Once the correct nerve is identified, your provider will inject numbing medication into the nerve. If pain relief is achieved, then radio waves are sent through the needle to burn the offending nerve. The nerve will die over the next couple of weeks and pain relief will likely be experienced.

Am I a candidate for radiofrequency facet denervation?

You are a candidate for radiofrequency facet denervation if you have significant back pain not related to a disk herniation that doesn’t improve with rest, ice, and anti-inflammatory medications. Your provider will determine if radiofrequency facet denervation is an appropriate treatment for your back or neck pain. Make sure your provider knows all of the medications you take and any drug allergies you have. You should stop taking blood thinners like Coumadin, heparin, or aspirin before and after the procedure, but speak with your provider before stopping these medications.

How long will the radiofrequency facet denervation procedure take?

You will remain in the office for a couple of hours after the procedure for observation. However, the procedure itself only takes an average of a half hour to an hour and a half. An intravenous catheter is inserted and calming medication is administered. You should have someone with you to drive you home; you should not drive the day of the procedure.

How long will it take to recover from radiofrequency facet denervation?

Many patients report a “sunburned” feeling over the site for a week or two. Muscle spasms and pain are to be expected as well. You should plan to rest the day of the procedure, but can return to work the next day. Your provider will likely order physical therapy for guided muscle strengthening and rehabilitation following the procedure. It generally takes up to two weeks to achieve full results. After a period of about two years (give or take a few months), the nerve will grow back; the pain may or may not come with it. If pain does return, the procedure can be repeated as necessary. It should be noted that despite the nerve being destroyed, it does not affect movement or function. Additionally, you are not at a higher risk for injuring the area even though you can’t feel sensation.

Reference:

Baker, R. (2013). Radiofrequency neurotomy for facet and sacroiliac joint pain. Spine-Health. Retrieved from https://www.spine-health.com/treatment/injections/radiofrequency-neurotomy-facet-and-sacroiliac-joint-pain