A lumbar facet radiofrequency neurotomy, also known as radiofrequency ablation, radiofrequency thermocoagulation, or radiofrequency rhizotomy is a procedure used to alleviate nerve pain originating from the spinal joints of the lower back. This treatment may be performed if the patient has experienced previous relief from nerve blocks administered to this area.
Facet joints are pairs of small joints located between the vertebrae and the back of the spine. These joints provide support for the spine while facilitating motion, including bending, flexing and twisting. Each facet joint is connected to two small medial branch nerves that carry signals (including pain signals) from the facet joints to the brain. Facet joints are susceptible to “wear and tear” over time or from a sudden injury. Potential conditions that affect the lumbar facet joints can include:
- Bone spurs
- Enlarged joints
- Spinal stenosis
Am I a Candidate for Lumbar Radiofrequency Neurotomy?
Facet joint syndrome in the lumbar spine can cause painful symptoms to develop in the lower back, buttocks and the back of the thighs. Pain and stiffness related to facet joint syndrome may make movements like standing up and rising from a chair difficult.
Typically, to identify whether or not the facet joints are the source of your pain, your doctor will perform a medial branch block (nerve block). This type of diagnostic nerve block essentially targets a nerve or group of nerves that are suspected to be the source of the patient’s pain. Small amounts of local anesthetic are injected onto the nerve(s) to temporarily disrupt the pain signals from reaching the brain. The patient is then assessed to see if there is any alleviation from their symptoms.
If a particular medial branch nerve or group of nerves is determined to be the source of pain, then a lumbar facet radiofrequency neurotomy may be recommended.
What is Lumbar Facet Radiofrequency Neurotomy?
A lumbar facet radiofrequency neurotomy essentially works by “turning off” the nerve that is transmitting pain signals. This is done by creating a heat lesion on the nerve to disrupt its ability to send pain signals to the brain.
Lumbar radiofrequency neurotomy is a safe and effective procedure which begins with the patient lying face down on a table. The skin and tissue over the treatment site are first injected with a local anesthetic to numb the area. Next, using an x-ray guidance device known as fluoroscopy, the physician will carefully guide a special type of needle into place alongside the medial nerves.
To ensure that the needle is properly placed next to the target nerve, a small amount of electrical current is passed through the needle to stimulate the nerve. This may cause muscle twitching. Once the doctor has confirmed that the needle is in the correct position, radio waves are then delivered to the nerve. These heat-generated waves disrupt the medial branch nerve that is carrying the pain signals, impairing the nerve’s ability to transmit signals about facet joint pain.
Once the procedure is complete, the patient is monitored for a short period of time before being discharged home with after-care instructions. The patient may be sore for a few days, but should be able to return to work the following day. Full pain relief can take anywhere from 2 – 4 weeks to take effect. You will be asked to keep track of your pain to help your physician determine the next step in your treatment plan.
As with most spinal injection procedures, results of lumbar radiofrequency neurotomy vary from patient to patient. For the majority of individuals, this treatment provides significant pain relief, enabling the patient to participate in a rehabilitation program.
Schedule an Appointment with Our Providers
If you are experiencing chronic pain of the lower back, buttocks, hip or groin, then you may be a candidate for lumbar radiofrequency neurotomy. Our providers will evaluate you to determine if this procedure would benefit you, or if another non-invasive treatment would provide you with pain relief.