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Radiofrequency Facet Denervation

Overview

This is used to treat central neck or back pain associated with arthritis. Doctors first diagnose the nerve blocks and then perform the denervation therapy.

Facet Joints, located in the spine from the neck to the tailbone, can become damaged during normal activities, with age, or due to inflammatory diseases, such as Rheumatoid Arthritis. If pain from damaged joints does not improve with physical therapy and/or medications, doctors might suggest RFD.

The diagnostic procedure

For the first part of the treatment, doctors use an X-ray to guide a needle to the nerve connected to the damaged joint. Once the needle is in place, the doctor injects some local anesthetic to numb the nerve. After the injections are complete, the patient compares the pain level before and after the procedure. The numbing effect from the injections is temporary, and it might take injections on separate days to make an accurate diagnosis.

If patients experience a temporary improvement in pain, the doctor might suggest continuing with the RFD.

The RFD procedure

Patients are sedated for this part of the RFD. Using an X-ray, the doctor places a special needle in the nerve for the damaged facet joint. After injecting local anesthetic to numb the nerve, the doctor heats the needle to damage a portion of the nerve. This does not damage nerves that go to the arms or legs, and does not further damage the joint.

Patients might still have some pain for up to two weeks after an RFD and could be prescribed pain medication for this period. After two weeks, patients follow a physical therapy program to help with pain and with movement after the procedure.

Patients having diagnostic nerve blocks or RFD should not eat on the day of their procedure and will need a driver to take them home after the procedure.