Radiofrequency denervation, also known as facet rhizolysis, radiofrequency ablation, or radiofrequency neurotomy, is a medical procedure used to alleviate neck and back pain caused by issues in the facet joints. The spine comprises a column of vertebrae stacked on top of each other. Like hinges, the facet joints are paired between each vertebra, ensuring stability while allowing bending and twisting movements.
These facet joints can become inflamed due to injury, trauma (like whiplash), poor posture, structural problems, or degeneration. This inflammation leads to pain around the affected joints, which can also spread. The lower back facet joints, in particular, can cause referred pain in the buttocks and upper legs, while facet joints in the neck can result in pain in the back of the head, upper back, and shoulders. Sensitivity and tenderness in the facet joints can cause nearby muscles to become tense and painful.
Radiofrequency denervation deactivates the nerves that supply the facet joints. This prevents these nerves from transmitting pain signals to the brain when the facet joints are inflamed.
Florida Spine and Pain Institute offers Radiofrequency denervation and other pain management treatments. Dr. Placer and his experienced staff have earned the trust of thousands of patients who rely on his accurate diagnosis and treatment of their pain conditions. This article discusses everything you need to know about Radiofrequency denervation and how it can help you control pain.
What is Radiofrequency Denervation?
Radiofrequency denervation is a minimally invasive procedure that utilizes radio waves to create a current that heats a small area of nerve tissue. The application of heat destroys the nerve area being targeted, interrupting the transmission of pain signals to the brain. The procedure offers long-lasting relief for individuals suffering from chronic pain, especially in the neck, lower back, and arthritic joints.
Why is Radiofrequency Denervation Performed?
The primary goals of radiofrequency ablation are:
- Alleviating or reducing pain
- Improving overall function
- Decreasing reliance on pain medications
- Avoiding or postponing the need for surgery
What Conditions Can Be Managed With Radiofrequency Denervation?
Radiofrequency ablation is effective in treating a range of conditions, including:
- Chronic pain results from spinal arthritis (spondylosis) and sacroiliac joint pain
- Neck, back, and knee pain
- Cancer pain
- Trigeminal neuralgia-induced facial pain
- Peripheral nerve pain
- Heart rhythm issues
- Tumors (to induce cell destruction)
How Does Radiofrequency Denervation Work?
Radio waves generate heat to target and damage the diseased tissue. When applied to nerve tissue, the heat disrupts the nerves, preventing or stopping the transmission of pain signals to the brain, resulting in pain relief.
During the radiofrequency denervation procedure, a small hollow needle is inserted into the targeted nerve responsible for the pain. An electrode is placed within the needle to transmit radio waves to the nerve. The generated heat creates a lesion that blocks the nerve’s ability to signal pain to the brain. This procedure does not harm the nearby healthy nerves.
Pain Management Within the Spine
Radiofrequency denervation is often used to manage pain originating from joints, such as the knee, as well as pain associated with the spine, particularly the neck and lower back.
Within the spine, nerves branch out from the spinal cord and extend to the facet and sacroiliac joints. Facet joints between the vertebrae provide flexibility and enable back movements like twisting and bending. Medial branch nerves, two small nerves connected to the facet joints, transmit pain signals to the brain when these joints are the source of pain.
Sacroiliac joints near the base of the spine above the tailbone are connected to lateral branch nerves that relay pain signals from the spine to the brain. Radiofrequency denervation is used to treat the targeted lateral branch nerve in the sacroiliac joints or the medial branch nerve in the facet joints, effectively reducing the transmission of pain signals to the brain.
Who is Eligible for Radiofrequency Denervation?
Individuals may be suitable candidates for radiofrequency denervation if they:
- Experience pain relief following a nerve block injection, indicating that the specific nerve is the source of their pain and can be targeted
- Suffer from chronic pain unresponsive to other treatments, such as pain medication and physical therapy
However, individuals may not be eligible for radiofrequency denervation if they:
- Are pregnant
- Have an infection
- Have a bleeding disorder
What Occurs Prior to a Radiofrequency Denervation Procedure?
Before the procedure, the healthcare provider will review the individual’s medical history, including medication usage, and inquire about their pain symptoms. If the individual takes aspirin or other blood-thinning medications, discontinuing them a few days before the procedure may be necessary.
A physical examination will be conducted, and imaging tests such as X-rays may be ordered to assess the individual, determine the level of arthritis or spinal injury, and rule out other potential causes of their pain. A diagnostic block involving the injection of a local anesthetic near the pain site may be performed to confirm the source and level of pain, which can help predict the potential degree of pain relief the individual may experience.
If the diagnostic block does not provide significant relief, radiofrequency denervation may not be beneficial. However, if the individual responds favorably to the diagnostic block, their healthcare provider may recommend radiofrequency denervation as a treatment option to alleviate their pain.
What Happens During the Procedure?
During the procedure, the individual lies on their stomach on a specialized X-ray table, monitoring their condition using various devices. They remain conscious and able to respond to the provider’s inquiries, although relaxation medications may be administered if desired.
A local anesthetic is applied to numb the skin area where the needle will be inserted. A thin needle is then inserted into the pain site, guided by fluoroscopy, a type of real-time continuous X-ray imaging. Once the needle reaches the intended site, a test is conducted by inserting a microelectrode through the hollow needle. The individual is asked if they feel a tingling sensation, discomfort, or muscle spasm. These sensations indicate that the correct location for treatment has been identified.
A local anesthetic is injected to numb the target area. A radiofrequency current is transmitted through the needle, heating the designated nerve area. The current destroys the nerve area, preventing it from transmitting pain signals to the brain.
If necessary, multiple nerves can be treated during the procedure.
How Long Does the Procedure Last?
The duration of the procedure can span from 15 minutes to two hours, depending on the treatment location and the number of nerves requiring treatment.
What Happens After the Procedure?
The individual can usually go home shortly afterward, but they must have someone drive them. Rest is recommended upon arriving home, and strenuous activities and driving should be avoided for 24 hours. After a day or two, they can resume normal activities, including bathing or showering.
Muscle spasms and pain at the treatment site may continue for a few days. Pain medication prescribed by the healthcare provider can alleviate these symptoms. Applying an ice pack to the site for 20 minutes at a time, several times during the first day of recovery, can also provide relief. Long-term success is heavily dependent on physiotherapy to strengthen core muscles and reduce the likelihood and severity of pain recurrence.
Radiofrequency Denervation is Available at Our Davenport, Clermont, and Orlando, Florida locations
For more information about how radiofrequency denervation can benefit you, feel free to contact Dr. Javier Placer and his team of professionals.
Begin your journey toward pain relief by scheduling a consultation.