Chronic low back pain?
Chances are you have had at least one episode of low back pain – 80% of the population report at least one instance in their lifetime and in 30% of these, the pain will recur. If the low back pain continues longer than 4-6 weeks you may be suffering from zygapophysial joint pain, which is commonly known as “facet syndrome” or facetogenic low back pain.
The facet joints connect the vertebrae posteriorly. These joints are found on either side of the spine in the neck, upper back and low back. Facet joint pain occurs when the joint or connecting capsule and or ligaments become inflamed or when the cartilage in the joint wears out or is injured.
It is estimated that facet pain is the cause of chronic low back pain up to 50% of the time in patients over the age of 50 years old.
A good way to accurately diagnose facet joint discomfort is to block the pain signal in the nerves (medial branch nerves) that supply the joints. These diagnostic medial branch blocks are performed as an outpatient procedure under live x-ray. The test involves minimal discomfort and takes less than 10 minutes for the Spine Care physician to perform.
If medicine and therapy are unsuccessful, one proven treatment for this source of back pain is Radiofrequency Neurotomy (RFN). This common modality is often performed in a surgery center and unlike surgery involves no incision. Local anesthetic and a mild sedative are used to keep the patient comfortable. Thin needles are placed next to the medial branch nerves that supply the facet joints. Radiofrequency energy is then used to disrupt the medial branch nerves. Patients typically feel some pain relief with in 1–2 weeks.
In 12–24 months the body may regenerate the nerves that supply the facet joint and if the discomfort returns another RFN can safely be performed.