Advanced Pain Therapies
 
Facet RF ablation
One of the treatment options available in relieving isolated back and neck pain is radio frequency lesioning. Though it has been available for over 30 years, the "why" it works to relieve pain has not always been understood. Radio frequency lesioning is a technique of nerve root disruption. And, it is the disrupting of the nerve root that relieves pain.

Traditional radio frequency lesioning involved placing a needle very close to the affected nerve. An electrical current heated the tip of the needle, burning the nerve, and, in turn, disrupting the pain pathways associated with it. Originally those utilizing the procedure thought the "burning of the nerve" disrupted the pain. But, the burning of which nerves seemed to be in question. They discovered that burning certain types of nerves actually could produce pain problems far in excess of the original problem, while burning other types of nerves caused no significant complications and worked to relieve the pain.

Through the years, researchers have sought to determine whether it was the actual burning and destruction of the nerve that relieved the discomfort or some other mechanism in the process. They discovered that the electromagnetic field generated during the delivery of the electrical current was the primary energy force responsible for relieving the pain. This discovery meant that it was often not necessary to actually destroy the nerve to relieve the pain, but rather to produce a high-energy electromagnetic field very close to the nerve responsible for the pain. Although there are many theories on how this actually works, there is still no definitive answer on the mechanism in action. Importantly, though, the results of radio frequency lesioning in relieving isolated back and neck pain have been very impressive. Additionally, the nerves remain intact using the 'pulsed' radio frequency technique.

Thermal and Pulsed radio frequency is very effective in treating isolated back and neck pain. As the pain is isolated, it does not radiate to other extremities. The isolated pain that the patient feels is often the result of an inflammation of the small joints in the spine. A tiny branch of the nerve root supplies these small jointsfacet joints which exit the spine at each spinal level. The nerve root, termed the medial branch nerve, can be selectively blocked to diagnose whether or not the pain that the patient is experiencing is arising from the facet joint itself. If the pain is reduced by blocking the medial branch nerve, then often radio frequency lesioning will be effective. By delivering pulsed radio frequency, the pain emanating from the affected nerve can be reduced for 2 or 3 months, thermal radiofrequency can extend the relief to 6 to 18 months.