Treating Low Back Pain – Radiofrequency Denervation

Most back pain arises from facet joint irritation. Facet joints are highly sensitive to pain, and they are easily affected by local inflammation, postural changes, and muscle spasms.

Radiofrequency denervation is a relatively new experimental technique that is being investigated to determine if it can be used to improve low back pain originating from facet joints. The principle is to blast away the nerves of a facet joint using very high temperatures, thus preventing them from transmitting pain.

Damaging nerves in this way has its dangers. Many of the nerves in the facet joints are proprioceptive nerves (position sensing), and it is impossible to distinguish between different types of nerve when using radiofrequency denervation. One outcome of diminishing your proprioceptive ability is to predispose to early wear and tear. Since wear and tear is a major cause of back pain, muscle pain, and immobility, this is a major contraindication of this procedure.

Radiofrequency denervation, also known as rhizolysis, also seems to have a very low success rate, with only 22% experiencing pain relief at 12 months. This is hardly surprising when we consider what happens when we damage nerves by accident: Phantom limb pain and post-surgery hyperaesthesia are both common examples of long term pain caused by physical nerve damage.

A success rate of only 22% does not compare well with what is seen if patients are left untreated either. Most facet joint originating pain is episodic, with patients getting periods of remission several times a year without treatment.

When compared to other successful forms of treatment for back pain, such as over the counter pain relief, spinal manipulation, and exercise advice, the technique of radiofrequency denervation is an unnecessarily harmful, expensive, and ineffective method of treatment.

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