Lumbar Radiofrequency Ablation

A LUMBAR RADIOFREQUENCY ABLATION (RFA) is an outpatient procedure for treating lower back, buttock, hip and groin pain. It is also called lumbar facet thermal coagulation or rhizotomy.  This information has been provided by your doctor so you can better understand this procedure. Your doctor will make the best recommendation for your specific needs.

Lumbar Radiofrequency Ablation (RFA) for Chronic Lower Back Pain

WHAT ARE LUMBAR FACET JOINTS?

Facet joints connect the vertebrae (the bones of the spine) and help guide the spine during movement. The lumbar region of the spine contains five vertebrae and is located in the lower back. Facet joints are found on both sides of the spine. Each is about the size of a thumbnail. Lumbar facet joints are named for the vertebrae they connect and the side of the spine where they are found. The right  L4-5 facet joint, for example, joins the 4th and 5th lumbar vertebrae on the right side. Medial branch nerves, located near facet joints, transmit pain signals from the facet joints to your brain. In other words, these nerves tell the brain when a facet joint has been injured. Pain from an injured lumbar facet joint may range from muscle tension to more severe pain. Depending on which facet joint is affected, the pain may occur in an area from your lower back down to your buttocks.

WHAT IS LUMBAR FACET JOINT PAIN?

Lumbar facet joint pain is a result of injury, either to the cartilage inside the joint or the connecting  ligaments surrounding the joint.

HOW DO I KNOW IF I HAVE LUMBAR FACET PAIN?

If you have pain in one or more of these areas, and it has lasted longer than two months, you may have  lumbar facet pain. Common tests such as x-rays or MRIs may not always show if a facet joint is the reason for your pain.

WHAT IS A LUMBAR RFA?

During this procedure, radiofrequency energy is used to disrupt function of a lumbar medial branch nerve,  so that it can no longer transmit pain signals from an injured facet joint.

WHAT HAPPENS DURING AN RFA?

An RFA may start with an IV (medicine given intravenously) to help you relax. A local anesthetic (numbing medicine) may be used to numb your skin. The doctor will then insert a thin needle near the facet joint. Fluoroscopy, a type of x-ray, will be used to  position the needle. The doctor will then check that the needle is in the proper position by stimulating the nerve. This may cause muscle twitching and provoke some of your pain. With the needle in the correct position, the area will be numbed. Your doctor will then use radiofrequency  energy to disrupt the medial branch nerve.

WHAT HAPPENS AFTER AN RFA?

You will be monitored for up to 30 minutes after the injection. Before you leave, the clinic will give you discharge instructions as well as a pain diary. Keeping track of your pain helps the doctor know what the next step will be.

You may feel sore for one to four days. This is normal, and may be caused by muscle and nerve irritation.  Your back may feel numb, weak, or itchy for a couple of weeks. Be patient, as full pain relief normally takes two to three weeks.

HOW LONG CAN I EXPECT PAIN RELIEF?

Nerves regenerate after an RFA, but how long this takes varies. Your pain may or may not return when the nerves regenerate. If it does, another RFA can be done.

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