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Radiofrequency denervation, also known as facet denervation, is a specialised form of treatment to cause heat damage to the two nerves that supply the facet joints, small pairs of joints which link your vertebrae together.
These nerves transmit pain sensations from the joints but have very little other function. By damaging them, the nerves stop sending pain signals to your brain.
Radiofrequency denervation is also known as facet rhizolysis, radiofrequency ablation or radiofrequency neurotomy.
Dr Mo Faris, Consultant Interventional Radiologist, talks about our self-pay facet denervation procedure for lower back pain.
Generally speaking, back pain affects a huge portion of people at some point in their lives. The persistence of back pain can be life-limiting, reducing enjoyment and significantly impacting mental health. While no single solution can address all aspects of back pain, reducing the pain can help address related issues such as weight gain due to the inability to exercise. This can lead to improvements in self-belief, self-worth, confidence, and mental health.
The normal pathway for being referred for lower back pain involves seeing spinal surgeons. They assess the likelihood of the cause of the pain and conduct investigations, commonly an X-ray or MRI scan. If deemed appropriate, they may perform an intervention such as an injection. If you have a positive response to the injection, you may then be referred for denervation.
Facet denervation uses thermal heat to ablate the nerve endings that supply the facet joints in the back. Without nerve endings that sense pain, you don't feel the pain. Lower back pain can have multiple causes, and it can be difficult to pinpoint the exact cause despite various tests, including MRI. To identify the cause, an injection is often performed initially to see if there is relief and to quantify the improvement. If there is significant improvement, it indicates that a more prolonged response from facet denervation may be beneficial.
At Benenden, we have a great team of specialists, including fantastic spinal surgeons who will be your initial point of contact. They will likely refer you for an MRI, and you may then be seen by a physiotherapist or myself for either an injection or the denervation procedure.
On the day of the procedure, which is a day case lasting approximately 4 to 6 hours, you will have a cannula placed in your hand for sedation. You will be assessed by the sedation provider and myself, and we will go through the consent process. You will then be taken to the CT scanner, which is an open donut-shaped scanner, to guide the procedure. You will lie on your front, and markers will be placed on your back. The CT scan will help us position the needles accurately. Local anaesthetic will be applied to the skin, and the needles will be placed and confirmed by the scan. We will perform sensory and motor tests to ensure we target the correct nerves. Once confirmed, sedation will be administered, and the ablation will take about 3 minutes.
After the procedure, you will be taken to recovery and then back to the ward. You will stay for about two hours, depending on your response, and then you can go home. It is important not to drive yourself to the procedure and to have someone to take you home. Most people experience mild bruising or soreness afterward, and occasionally temporary numbness in the lower back and legs, which resolves within a few days.
The nerves may be inflamed after the procedure, taking up to two weeks to settle down. You may experience discomfort and soreness, and we advise taking your usual pain medication. The improvement from the procedure can last between six months to 18 months, and in some cases, even longer. It is important to use this pain-free period to stabilise and strengthen your core to support your back and reduce the risk of ongoing back problems.
Facet denervation is not a one-stop solution but can be part of chronic management for back pain. The frequency of the procedure depends on how quickly your nerve endings grow back. Some patients have yearly or bi-yearly denervation and maintain normal function in between.
Consultant Interventional Radiologist
Dr Faris's interests include cutting edge vascular and non-vascular interventional radiology procedures.
Language(s): English
Location(s): Kent
Consultant Spinal Specialist
Mr Ganesan is a specialist in the diagnosis and management of most aspects of lower spinal conditions.
Language(s): English
Location(s): Kent
Consultant Orthopaedic Spinal Specialist
Mr Mohamed's specialties include treatments for back pain and spinal conditions.
Language(s): English
Location(s): Kent
Consultant Orthopaedic Surgeon
Mr Selmon is Regional Coordinator for the NJR and has expanded his adult spinal practice.
Language(s): English
Location(s): Kent
Consultant Orthopaedic Surgeon
Mr Yanni's specialties include treatment for spinal conditions.
Language(s): English
Location(s): Kent
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