This medical procedure is often referred to as a minimally invasive procedure; heat from radio waves is utilized to provide pain relief from painful facet joints in the lumbar area or the lower back. This therapeutic medical procedure called radiofrequency rhizotomy, or neurotomy is designed to manage if not remove nerve pain manifestations that failed to respond to a more conservative medical care.
The technique requires terminating the nerves producing the pain with highly localized heat triggered with radiofrequency. By eliminating these nerves, pain signals from the spine going to the brain are blocked.
Preparation
The patient lies down on their stomach while getting ready for the procedure. The skin and tissue of the back is anesthetized using a local anesthetic.
Placement
A cannula is inserted to the area of the treatment and a fluoroscope, which is an x-ray device guides the cannula to the medial branch nerves innervating the facet joints of the spine. These tiny nerves send pain signals from the facet joints to the brain.
Treatment
An electrode is placed inside the cannula. A test signal is used to identify the correct placement. If the correct placement is achieved, the electrode is heated to cauterize the nerve, which in turn disrupts the nerve sending pain signals to the brain.
End of Procedure
Upon completing the procedure, the physician removes the electrode and cannula. A small bandage is then placed on the area of the skin where the cannula entered. Post procedure monitoring will be done, can be a few hours, before you are sent home. The area of your skin where the injection has been made may still feel sore with back pains after the procedure. Gradually, pain relief can be experienced in several weeks as you heal. Relief can be experienced for several months.
Radiofrequency ablation benefits
In a clinical research study for patients treated with radiofrequency therapy, 21% had complete pain relief, and 65% reported mild to moderate pain relief. Many of the respondents reported reduction in the use of pain medications. None of the patients developed significant infection, bleeding, hematoma formation, or numbness as complications to their therapy.
Radiofrequency ablation is an extremely safe, well-tolerated method selected to treat many causes of chronic pain. If your pain responds well to an initial treatment, a follow-up treatment may be helpful. As a non-invasive therapy for lower back pain, radiofrequency ablation helps to increase mobility, ease pain, and reduce the use of analgesics.
In a 2012 study, pulsed radiofrequency showed excellent pain relief for more than 80% of the patients. These same patients had positive outcomes at two, six, and 12 months (although pain relief percentages were slightly lower over time). Since pulsed radiofrequency does not destroy the nerve, a return in pain is to be expected as the nerves regenerate, and the treatment can be repeated.