Of the millions of chronic back pain sufferers in America, just less than half (45%) have the facet joints as their pain generator. This is termed facet joint syndrome. Facet joint injections are the most common interventional pain management procedure by far in the US. They work well about 80% of the time.
Even if a history, physical exam, and imaging establishes the diagnosis of facet joint syndrome, it may not actually be the pain generator. Even if arthritis is seen on a CT scan, xrays, and MRI it still does not mean the patient will have pain.
The best method available for determining whether or not a patient has facet joint syndrome is a diagnostic injection into the joint. This injection is when a pain doctor performs a diagnostic injection of numbing medicine around the facet joint to numb up the small nerve endings supplying sensation to the joint (and pain). If the patient's pain is substantially relieved from the numbing injection, then the diagnosis of facet joint syndrome is cemented.
Medial branch blocks and facet joint injections have been shown to give 5 to 7 months of pain relief on top of just confirming the diagnosis. When the pain comes back, the pain doctor can repeat the injections with similar results expected.
Radiofrequency denervation (ablation) was developed in the 1970's and 80's and subsequently modified as its popularity grew. It has gained popularity as more and more clinical studies have shown satisfactory outcomes.
Radiofrequency ablation (also called RF ablation) entails placing a catheter in the same region as where the previous medial branch block is performed. Instead of injecting numbing medicine and/or steroid, the catheter tip is heated with radiofrequency waves and the small nerve endings are deadened.
Outcomes of studies looking at radiofrequency ablation have been encouraging. Successful results after radiofrequency procedures have been seventy to ninety percent for a year with pain relief lasting for up to 2 years. This is over twice as long as an average facet joint injections. Eventually the medial branches that were deadened will grow back and the pain may come back. At that point the RFA may be repeated with similar satisfactory results expected. The RF procedure may allow patients to reduce their necessary pain medications.
It should be noted that patients may temporarily see increased pain after a radiofrequency ablation. This may be due to muscle spasms from the procedure. Typically within a week the pain relief will begin and the benefits will be noticed.
Radiofrequency ablations are performed as an outpatient. It can be performed with local numbing medicine or IV sedation. The procedure is relatively safe with low risks, but complications may ensue. This can include dural puncture, spinal cord trauma, infection, increased pain, or hyperesthesia/dysesthesias.
Even if a history, physical exam, and imaging establishes the diagnosis of facet joint syndrome, it may not actually be the pain generator. Even if arthritis is seen on a CT scan, xrays, and MRI it still does not mean the patient will have pain.
The best method available for determining whether or not a patient has facet joint syndrome is a diagnostic injection into the joint. This injection is when a pain doctor performs a diagnostic injection of numbing medicine around the facet joint to numb up the small nerve endings supplying sensation to the joint (and pain). If the patient's pain is substantially relieved from the numbing injection, then the diagnosis of facet joint syndrome is cemented.
Medial branch blocks and facet joint injections have been shown to give 5 to 7 months of pain relief on top of just confirming the diagnosis. When the pain comes back, the pain doctor can repeat the injections with similar results expected.
Radiofrequency denervation (ablation) was developed in the 1970's and 80's and subsequently modified as its popularity grew. It has gained popularity as more and more clinical studies have shown satisfactory outcomes.
Radiofrequency ablation (also called RF ablation) entails placing a catheter in the same region as where the previous medial branch block is performed. Instead of injecting numbing medicine and/or steroid, the catheter tip is heated with radiofrequency waves and the small nerve endings are deadened.
Outcomes of studies looking at radiofrequency ablation have been encouraging. Successful results after radiofrequency procedures have been seventy to ninety percent for a year with pain relief lasting for up to 2 years. This is over twice as long as an average facet joint injections. Eventually the medial branches that were deadened will grow back and the pain may come back. At that point the RFA may be repeated with similar satisfactory results expected. The RF procedure may allow patients to reduce their necessary pain medications.
It should be noted that patients may temporarily see increased pain after a radiofrequency ablation. This may be due to muscle spasms from the procedure. Typically within a week the pain relief will begin and the benefits will be noticed.
Radiofrequency ablations are performed as an outpatient. It can be performed with local numbing medicine or IV sedation. The procedure is relatively safe with low risks, but complications may ensue. This can include dural puncture, spinal cord trauma, infection, increased pain, or hyperesthesia/dysesthesias.
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Want to find out more about az pain clinics, then visit Preferred Pain Center's site on how to choose the best Phoenix chiropractor for your needs.
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