The facet joints are small joints on the back of your spine, and are found in all levels from your low-back to your neck. Facet joint pain is usually due to arthritis or degeneration of the joints and is usually described as an ache that stays along the spine and is worse with prolonged sitting, standing or driving. If your pain condition is consistent with facet joint pain, your physician will likely recommend one of the following procedures.
One method for relieving facet joint pain is to directly inject steroid and local anesthetic into the affected joints themselves. Facet joint injections are performed with x-ray guidance.
The small nerve which transmits pain impulses from the facet joint is called the medial branch nerve. This nerve can be blocked by the injection of local anesthetic and steroid under x-ray guidance.
In cases where either medial branch blocks or facet joint injections provided good relief that did not last enough, radiofrequency ablation may be performed to provide longer pain relief. RFA also targets the medial branch nerve, but uses radiofrequency energy (a type of heat) to stun the nerves. This procedure can provide pain relief for up to 6- 12 months.
Facet joint injections are usually done at up to six sites at a time and take 10 to 15 minutes. Radiofrequency ablation usually takes roughly 30 minutes.
Radiofrequency ablation does not permanently destroy (or “burn”) the medial branch nerves. The nerves will slowly regenerate/grow back over time, which is why this procedure may need to be repeated.
The majority of patients feel relief of their usual pain shortly after the procedure due to the injection of local anesthetic on the medial branch nerves. However, some patients will experience temporary muscle stiffness.
Relief from injections is highly variable and can range from weeks to a month or two. Relief from RFA is more predictable and typically lasts up to 12 months.