Radiofrequency Denervation Therapy
Radiofrequency denervation is used to treat chronic pain that originates in the facet joints
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Radiofrequency denervation is used to treat chronic pain that originates in the facet joints. These are the small joints on either side of the spinal column that link the vertebrae together, and they can become painful for a number of reasons. This most commonly involves ‘wear and tear’ degenerative changes in the spine due to injuries, osteoarthritis, disc changes, and changes that can reduce the mobility of the joints and the amount of space around them, resulting in inflammation and pain.
Pain is often felt in the areas around and below the joints too. So, for example, painful facet joints in the lumbar spine may result in pain in the buttocks and legs too. Facet joint pain can range from mild to severe, and often responds well to conservative treatments including physiotherapy, exercise, heat patches and nonsteroidal anti-inflammatory drugs (NSAIDS). But in some people, facet joint pain can become chronic and more difficult to manage.
Radiofrequency denervation involves using highly localised heat produced at the tip of a needle by radio waves, to de-function the nerves that link with the affected facet joint. The procedure is carried out on a day case basis, meaning you’ll be able to go home shortly afterwards. You’ll need to be awake during the procedure, as the consultant will need to communicate with you during it, and ask you what you can feel; however local anaesthetic will be used to numb the area first and, if required, sedation can be used to help you relax. The radio waves are administered via a needle, with X-ray used to help guide the needle into the correct position. The consultant will then deliver a very small electric current along the needle, to check it’s targeting the correct nerves. You might feel some tingling and twitching but it shouldn’t be painful. Next, the radio waves are delivered. Depending how many nerve treatments are needed, the treatment may be completed in one session, or you may need to return for a second session if a large number of nerves are being treated.
Afterwards, you’ll be monitored briefly before going home. You won’t be able to drive for at least 24 hours, so will need somebody to accompany you. Some soreness after the treatment is normal, and some people find their pain temporarily increases before it gets better. Painkillers will help and, while you may need to avoid strenuous activity for a short while, it’s important to keep mobile and active – your consultant will be able to advise on this.
Radiofrequency denervation is rarely 100% successful. However, many people experience a significant improvement in their facet joint pain that can last around 6-12 months, sometimes even longer, and physiotherapy can also promote this improvement. If the treatment is effective, you can discuss further sessions in the future.