Your facet joints are bony protrusions that run all along your vertebrae. Facet joints protect and support your spinal cord. The facet joints also allow your spine to twist and bend with ease — unless your facet joints are inflamed.
When you have arthritis or another condition that causes inflammation in the soft tissues that line your facet joints and it irritates the nearby medial branch nerves, the pain can be excruciating. While facet joint injections can offer short-term relief, they don’t work for everyone and you may be tired of going back for new injections every few months.
When you suffer back or neck pain due to swollen and irritated facet joints and nerves, Louis J. Raso, MD, PA, a pain-management specialist in Jupiter, Florida, may recommend facet rhizotomy. Here, he explains what this simple procedure is and why it may be the pain solution you’ve been looking for.
Facet rhizotomy is a minimally invasive procedure that is sometimes referred to as radiofrequency (RF) ablation. When Dr. Raso treats your neck or back pain with facet rhizotomy, he administers RF energy to the affected nerve in your facet joint until the nerve is stunned or destroyed.
After facet rhizotomy, the treated nerve can’t send pain signals to your brain. You experience relief from neck or back pain that can last for months to years at a time.
When you’ve injured your back in a fall or accident, the soft tissues in your facet joints might be in a constant state of inflammation. The inflammation presses on the nerves near the facet joints, sending intense pain signals to your brain. Arthritis in the facet joints can also irritate the medial branch nerves.
Dr. Raso usually recommends physical therapy and facet joint injections as a first-line therapy for pain in your facet joints. Facet joint injections also act as a diagnostic tool. If they work, then Dr. Raso can be confident that the medial branch nerve near the facet joint is causing your pain and that destroying it will alleviate the pain.
You don’t undergo general anesthesia during facet joint rhizotomy. In fact, it’s important that you’re awake so that Dr. Raso can communicate with you and verify that the procedure is dulling your pain.
For the operation, you lie prone on your stomach. Dr. Raso or a team member injects the treatment area with an anesthetic so that you won’t feel pain when he makes a small incision.
Using X-ray guidance, he locates the medial nerve to be treated and inserts a tiny needle electrode into it. He then runs RF energy through the electrode to destroy the nerve. If he’s treating a facet joint in your neck (i.e., cervical spine), he may use a technique called pulsed RF that stuns the nerve rather than burning it.
He may need to treat more than one nerve to eliminate your pain. The entire procedure generally only takes between 30-60 minutes.
Unlike nerve blocks that can wear off in weeks to months, most facet rhizotomy procedures alleviate your pain for up to a year. Dr. Raso refers you to a physical therapist to help you recover from the procedure and also to strengthen your back and core muscles to give your spine the support it needs to function well and painlessly.
To find out if you’re a candidate for facet rhizotomy, call us at 561-264-2929 or contact us using our online form.