Radiofrequency Ablation of the Medial Branch Nerves
is a safe and effective way to relieve chronic lumbar (lower back) pain using radio waves to create heat. These radiofrequency waves are electromagnetic waves that travel at the speed of light and blocks nerve tissue from transmitting pain signals to the brain. The medial branch nerves are sensory nerves that carry pain signals from injured facet joints to the brain. Facet joints are parts of the spinal bones (vertebrae) that allow one to do a wide range of motions. Injury or degenerative changes in these joints, particularly in the lower back, can cause inflammation and severe pain, which may not respond to conservative medical therapy. (click picture to enlarge)
How Radiofrequency Ablation Works
Radiofrequency ablation provides long-term pain relief that exceeds the effects of a nerve block or other types of injections. Various types of chronic pain conditions respond well to radiofrequency ablation including pain from previous spinal surgery, whiplash injury, complex regional pain syndrome and spondylitis (arthritis of the spine).
The procedure involves the placement of insulated needles with a tiny electrode next to the medial nerve branch. A small radiofrequency current is directed to the medial branch nerve of the facet joint for 60-90 seconds, which generates heat (60-80 degrees Celsius) that destroys the nerve tissue. The result is blockage of pain signals to the brain.
Radiofrequency ablation is a relatively safe and common technique that can provide dramatic and long-lasting pain relief without systemic side effects. Patients benefit from this procedure because pain is reduced for several months, allowing the patient to resume normal activities and undergo rehabilitation or physical therapy while healing takes place.
Radio Frequency Ablation for Back Pain: General Procedure
Radiofrequency ablation is an outpatient procedure performed by a qualified Chronic Pain Specialist who is an expert with the treatment. The patient is initially briefed about the procedure and prepared beforehand so that he is relaxed.
The patient needs to be relaxed but alert during the procedure to help the doctor correctly place the electrode used during nerve ablation. The procedure will take 20-45 minutes, with the patient lying on their stomach (prone). After the skin is properly sterilized, local anesthesia is injected to numb the area.
Using x-ray guidance, insulated needles are directed next to the targeted medial nerves. The doctor will use X-rays to guide twin, insulated needles with an electrode are placed next to the nerve. During the procedure, the doctor asks the patient if he feels a tingling sensation or a muscle twitching. These signs will help ensure the electrode is properly positioned. Once the needle and electrode are placed correctly, the nerve is heated with radio waves until pain signals to the brain are blocked.
Post Operative Recovery after Radiofrequency Ablation Procedure for Back Pain:
After the procedure, the patient is monitored in a recovery area and discharged when stable. The patient may feel some local pain for several days after the procedure, which may be relieved by oral medications. Some swelling or bruising may occur where the needle was inserted and this may be reduced by applying a cold pack. It may take weeks for the full effects of radiofrequency ablation to be felt, but the pain relief may last for six months or even longer. Some nerves grow back, and radiofrequency ablation may need to be repeated.
Radiofrequency Ablation of the Medial Branch Nerves is a minimally invasive, safe, and effective means of treating low back pain that is unresponsive to other forms of treatment. If you want more information about treating chronic low back pain, contact our Pain Management Specialist who will examine you and conduct tests to determine the cause of your back pain. Make an appointment with the NYC’s top board-certified interventional pain management physician to know if radiofrequency ablation is a treatment option for you.