A friend of mine, who is in his eighties, has been living with back pain for decades. He has found relief from that pain through a procedure known as radiofrequency neurotomy (also known as radiofrequency ablation). But a change of doctors created a problem. His new doctor would not provide a referral when it was time for his next treatment.
My friend’s case is not unique. Despite decades of use, some doctors are still skeptical of radiofrequency neurotomy. Their reservations prevent them from giving patients the referrals they so desperately need. Instead, they prefer to treat with the prescription pad. Some even recommend surgery. My friend, like so many others his age, is not interested in back surgery so late in life.
Radiofrequency Neurotomy: The Basic Premise
The basic premise of radiofrequency neurotomy is pretty simple. It was developed with the understanding that a person will not feel pain if pain signals never make it to the brain. In other words, pain is a physical sensation triggered when the brain receives signals from a given part of the body. Where there are no pain signals, there is no sensation of pain.
Radiofrequency neurotomy interrupts pain signals by creating a temporary lesion on the targeted nerve. The lesion acts as a nervous system roadblock, so to speak. Pain signals cannot get through, so the brain does not trigger the sensation.
Not for Every Type of Back Pain
At this point, it’s important to note that radiofrequency neurotomy isn’t appropriate for every type of back pain. Lone Star Pain Medicine out of Weatherford, Texas, explains that the treatment is reserved mostly for pain caused by facet syndrome. In a facet syndrome scenario, pain radiates directly from the facet joints in the spine.
It is also worth noting that the treatment usually isn’t recommended as a first-line treatment. Doctors would prefer to try more conventional means before going the radiofrequency neurotomy route. But when pain medications, exercise, and physical therapy prove unsuccessful, radiofrequency neurotomy could be a patient’s only ticket to legitimate pain relief.
A Minimally Invasive Procedure
Despite its impressive-sounding name, radiofrequency neurotomy is a minimally invasive procedure involving a small incision, a cannula (a small tube), and an electrode. The patient lies on his front with his lower back exposed. A topical anesthetic is applied to numb the skin followed by a small incision being made.
Using a fluoroscope, the doctor guides the cannula through the incision and right to the targeted nerve. The electrode is then fed through the cannula. Once placed, the electrode delivers a burst of radio waves that form a lesion on the nerve. The electrode and cannula are then removed, the wound bandaged, and the patient observed for a short period before being sent home.
The patient is likely to still experience some amount of back pain until the wound heals. Within a few days, however, back pain begins to subside. Most patients experience significant pain relief within 4-6 weeks. As for how long the pain lasts, 6-12 months is average.
There Is Science Behind It
One of the first studies proving radiofrequency neurotomy’s efficacy was conducted in 1994. A more recent study, published in 2020, verified the procedure’s efficacy across a wider variety of paint types – including chronic low back pain.
The truth is that radiofrequency neurotomy has science behind it. It works for many patients, and quite well. It is unfortunate that so many doctors still have reservations about it. On the other hand, it’s equally fortunate that pain specialists like Lone Star make the procedure available to those who want it.