Facet Blocks and Facet Radiofrequency Procedures

What is a facet block?
The facet joints are small joints throughout your spine, where one vertebra connects to another. These joints can be damaged by aging, inflammation, injury, or accidents. Once damaged, the joint may cause severe back pain. The diagnosis is usually confirmed by injection of the joint or nerve (medial branch nerve) that transmits pain sensation from the spinal cord and brain.

What is radiofrequency lesioning?
Radiofrequency lesioning (rhizotomy or ablation) is a long-acting procedure used to treat facet pain that previously responded well to a short-acting trial diagnostic facet block in the neck (cervical), mid-back (thoracic), or lower back (lumbar). This lasting procedure may provide many months to years of excellent pain relief.

What happens during a facet procedure?
We will start an IV so that we can administer some medication to relax you and relieve any discomfort. We then scrub your back with a cleaning solution while you lie on your stomach so that we can clearly visualize the bony areas where the medial branch nerves reside. We will numb a small area of skin and use X-ray guidance to place an injection near the facet joint with local anesthetic and a steroid for the diagnostic block. A radiofrequency, heated needle tip will be used to lesion the nerve during a rhizotomy. This heat will slightly burn the medial branch nerve causing proteins to clump inside the nerve and interrupt the pain signals.

What will happen after a facet procedure?
You will first rest in the recovery area for 30-60 minutes before being discharged to go home. Your back may feel numb or weak for a few hours, but this is normal. You should start feeling some relief in about 24-72 hours after a diagnostic block, but it may take 2-3 weeks after the rhizotomy. A few days of discomfort after the procedure (usually like a sunburn-like sensation) is normal.

For your own safety, you cannot drive the day of the procedure, so please plan to have someone drive you to and from your appointment. The day after the procedure, you may resume normal activities and work.