Radiofrequency Facet Denervation
Radiofrequency facet denervation (RFD) is a minimally-invasive surgical procedure used to treat central neck or back pain caused by arthritis or injury to the facet joints. This procedure is also called lumbar radiofrequency neurotomy or radiofrequency rhizotomy.
The facet joints are small joints at the back of your spine that 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 can cause pain by pressing on nearby nerves. If pain caused by the damaged joints does not improve with physical therapy, medications, or both, doctors might suggest RFD. Your doctor tests the nerves to determine which ones are causing pain, then treats the nerves to stop them from sending pain messages.
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 radiofrequency facet denervation to relieve your pain.
The RFD procedure
Radiofrequency facet denervation is performed on an outpatient basis, with no overnight hospital stay. Prior to the procedure, you will need to follow eating and drinking restrictions as outlined by your doctor. You will also need to arrange for someone to take you home afterwards.
Your doctor will begin the procedure by giving you sedative medication to make you relax and minimize discomfort. If you need to, you can talk to your doctor during the procedure.
Using an x-ray for guidance, the doctor places a special needle in the nerve connected to 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 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.
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 may start a physical therapy program to help reduce pain and improve function.
Watch our radiofrequency facet denervation animated video to learn more about this procedure.
If you think RFD might be right for you, use our Self-Referral Tool to determine which OHSU Spine Center specialist you should see to discuss your condition. Contact us to schedule an appointment at 503 418-9888.