Radiofrequency Facet Denervation
Radiofrequency facet denervation (RFD) is used to treat central neck or back pain caused by arthritis. This procedure is also called lumbar radiofrequency neurotomy. Your doctor tests the nerves to determine which ones are causing pain. Then the nerves are treated to stop them from sending pain messages.
The facet joints are small joints at the back of your spine. They help keep the spine straight. These joints can be damaged by:
- Normal activity
- Inflammatory diseases such as rheumatoid arthritis
- Injury or accident
The damaged facet joints press on nearby nerves. This causes pain. If pain caused by the damaged joints does not improve with physical therapy, medications or both, doctors might suggest RFD.
The diagnostic procedure
To test the nerves, your doctor uses 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. You might have more than one injection, depending on how many joints are damaged.
After the injections, you compare your pain levels before and after the procedure. The numbing effect from the injections is temporary. You might need injections on separate days to make an accurate diagnosis.
If your pain gets better after the injections, your doctor might suggest having RFD.
The RFD procedure
Using an X-ray to guide the needle, the doctor places a special needle in the nerve connected to the damaged joint. After injecting local anesthetic to numb the nerve, the doctor heats the needle to damage a portion of the nerve. This stops that nerve from sending pain signals. It does not damage nerves that go to your arms or legs, and does not damage the joint any further.
This procedure is done on an outpatient basis, with no overnight hospital stay. Your doctor gives you sedation, medicine to make you relax and minimize discomfort. If you need to, you can talk to your doctor during the procedure.
You might still have some pain for up to two weeks after RFD, and your doctor may give you medication to relieve this pain. After two weeks, you start a physical therapy program to help reduce pain and improve function.
If you have diagnostic nerve blocks or RFD, you should not eat before the procedure. You need someone to take you home afterwards.
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