Lumbar facet joint pain, that is, low back pain that has its origin in the facet joints, can be effectively treated through a minimally invasive therapeutic procedure. This treatment is known as thermal radiofrequency, and in this article we describe its application to the lumbar region, what it involves and how effective it is for treating pain.
Lumbar radiofrequency is a procedure that blocks the transmission of pain from nerves connecting to the interapophyseal joints, for a much longer period than a local anesthetic used with a corticosteroid would. The radiofrequency procedure uses an electrical power source to cause what is known as a thermal radiofrequency ablation (RFA).
Low back pain can be disabling for many people and radiofrequency techniques are a very effective resource in the treatment of that chronic pain. The patient does not need to be under general anesthesia for this procedure, however, at Instituto Clavel we sedate the patient to protect them from the unpleasant sensation of intense heat used during the procedure, which normally lasts between 30 and 45 minutes.
More information about lumbar rhizolysis performed at Instituto Clavel
How is a lumbar radiofrequency done?
It is performed under sterile conditions in the operating room, using an X-ray machine to guide the precise placement of a needle-shaped electrode. The main objective of this procedure is be to apply heat to the nerve in question in order to reduce the pain of the interapophyseal joint. To achieve this, special equipment is used to generate and control the energy on the electrode.
The doctor specialized in pain treatment, will place the electrode in a tangential position, as this improves the results. The procedure is ambulatory, the patient is admitted and discharged on the same day. To enhance the effects of the radiofrequency treatment, local anesthetics and corticosteroids are administered at low doses, and to minimize subsequent discomfort, oral analgesics are also prescribed.
Lumbar thermal radiofrequency ablation does not destroy the nerve, but alters the nerve's ability to transmit pain signals. This can provide pain relief that can last as long as 18 months. Here below, we describe two types of radiofrequency treatment:
- Thermal radiofrequency: with this technique it is possible to increase the temperature for a controlled burn type injury. It is normally used when there is low back pain without sciatica. A diagnostic block must be performed first, so that before applying heat, it is confirmed that the low back pain is produced by that nerve.
The diagnostic block is made through an X-ray machine and the nerve is anesthetized; if the pain goes away, then thermal radiofrequency can be performed.
- Pulsed radiofrequency: This procedure involves applying pulses of energy to the nerve roots, through a needle or probe. Unlike the previous procedure, this one is very useful in the treatment of sciatica; as well as in neuropathic pain. It can be done without a diagnostic block because there is no thermal injury.
How lumbar radiofrequency is performed
What steps follow a lumbar radiofrequency treatment?
The patient will be summoned to a follow-up appointment 2 to 4 weeks after the procedure (the time is set based on the criteria of the specialist). During that time, the radiofrequency should have taken effect. So it is important that you understand that it may take several days for the results of the treatment to be felt.
After the procedure, the doctor may recommend that the patient rest for the first 24 hours, but can gently return to normal activities over the next few days. Sometimes patients report feeling local pain at the injection site which can be treated with oral analgesics. They can usually expect the pain relief to last between 8 and 12 months. Sometimes, the effects last as long as 18 months.
It is important to know that this procedure can be repeated if the pain returns, as long as the doctor determines it is appropriate for your case and no new symptoms have appeared for another reason. Lumbar radiofrequency treatment should be accompanied in parallel with isometric exercises to strengthen the core and back muscles.
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Categories: Spine treatments, Lumbar pain, Pain Management