Radiofrequency facet denervation is a minimally invasive procedure used to treat central neck or back pain caused by arthritis or injury to the facet joints. This procedure is also called RFD, 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
• Aging
• Inflammatory diseases such as rheumatoid arthritis
• Injury or accident

The damaged facet joints can cause pain by pressing on nerves. The OHSU Spine Center is committed to trying options such as physical therapy or medications first. But if those don’t help, your doctor might suggest RFD. The treatment involves testing which nerves are causing pain, then treating them to stop sending pain messages.

Testing

Your doctor uses a type of X-ray called fluoroscopy to guide a needle to the nerve connected to the damaged joint. The doctor injects local anesthetic to numb the nerve. You might have more than one injection, depending on how many joints are damaged.

Next, you compare your pain levels before and after the procedure. If the injections reduce your pain, your doctor might recommend radiofrequency facet denervation. You might need injections on separate days to make an accurate diagnosis.

Treatment

You receive a sedative and local anesthesia. The doctor uses fluoroscopy to guide a needle to the nerve causing pain, then injects local anesthetic to numb the nerve. The doctor heats the needle to damage part of the nerve, preventing it from sending pain signals.

This is an outpatient procedure. You will need to follow eating and drinking restrictions, and you’ll need someone to take you home. You may receive medication to relieve pain as you heal. Physical therapy also might be recommended.

Conditions this treats

RFD might be recommended for:

• Back or neck pain
• Spinal arthritis