Facet joints are used to connect the vertebrae and they help guide your spine as you move. They are found on both sides of the spine and are named for the vertebrae they connect and the side of the spine in which they are found. For example, the left C2-3 facet joins the second and third vertebrae on the left side of the spine.
An injured thoracic facet joint can cause pain ranging from simple muscle tension to severe pain depending on the severity of the injury and the joint that is affected. The cartilage inside the joint can be injured; other times only connecting ligaments around the joint are injured. This pain can occur anywhere from your upper back and shoulder down to your hips, and usually lasts several months.
Because common tests like MRIs or X-rays don’t always show if a facet joint is causing pain, the best way to diagnose this pain is to block the pain signal in a medial branch nerve. RFA disrupts nerve function using radiofrequency energy and when done to a medial branch nerve, it cannot transmit pain from the injured joint.
The procedure may start with an IV to help you relax and a local anesthetic to numb your skin. The physician then inserts a very thin needle near the facet joint. Fluoroscopy, a type of X-ray, is used to ensure proper needle placement. The physician then checks to make sure it is at the correct nerve by stimulating it, this may cause muscle twitching. When the needle is in the proper place, that area is numbed. Radiofrequency energy is then used to disrupt the medial branch nerve, which is often repeated at multiple levels of the spine.
You will be monitored for 30 minutes following the injection, at which time you will be given your discharge instructions and be allowed to leave the clinic. You may feel sore for a few days, which is absolutely normal and is usually as a result of muscle and/or nerve irritation. A numb or itchy back for a couple weeks is also normal, with full pain relief coming in two to three weeks. The nerve will regenerate after an RFA and your pain may or may not return. In the event that your pain does eventually return, another RFA can be performed.