Lumbar Facet Radiofrequency Neurotomy in Cincinnati - APSI Wellness
Learn about lumbar facet radiofrequency neurotomy for chronic lower back pain. Long-lasting relief at APSI Wellness in Cincinnati.
Lumbar Facet Radiofrequency Neurotomy — Lumbar facet radiofrequency neurotomy uses targeted heat energy to disrupt pain-transmitting nerves from the lumbar facet joints, providing long-lasting relief for chronic lower back pain.
What Is Lumbar Facet Radiofrequency Neurotomy?
Lumbar facet radiofrequency neurotomy (also called radiofrequency ablation or RFA) is a minimally invasive procedure that uses heat generated by radiofrequency energy to disrupt the medial branch nerves that transmit pain signals from the lumbar facet joints. These small joints in the lower back are a common source of chronic back pain, especially as they degenerate with age or after injury.
By creating precise thermal lesions on the target nerves, the procedure interrupts pain signal transmission for extended periods — typically 9-18 months — without affecting spinal stability or muscle function.
How Does It Work?
Each lumbar facet joint is innervated by two medial branch nerves from adjacent spinal levels. When the facet joints become arthritic, inflamed, or injured, these nerves carry persistent pain signals to the brain.
During radiofrequency neurotomy:
A specialized insulated needle with an active tip is positioned alongside the target medial branch nerve using fluoroscopic guidance
Low-level electrical stimulation confirms accurate placement — sensory stimulation should reproduce the patient's typical pain, while motor stimulation verifies no motor nerves are at risk
Radiofrequency energy heats the needle tip to approximately 80°C for 60-90 seconds, creating a controlled lesion that disrupts the nerve's ability to transmit pain
This process is repeated for each target nerve, typically treating multiple levels in a single session.
Conditions Treated
Lumbar facet arthropathy — degeneration and inflammation of the lower back facet joints
Lumbar spondylosis — age-related degenerative changes in the lumbar spine
Chronic lower back pain — when facet joints are confirmed as the pain source through diagnostic medial branch blocks
Post-traumatic facet pain — chronic pain from facet joint injury following accidents or falls
Failed conservative treatment — when physical therapy, medications, and other non-invasive treatments haven't provided lasting relief
What to Expect During the Procedure
Before: You must have had successful diagnostic medial branch blocks (typically 80%+ pain relief) confirming facet joint pain. Blood-thinning medications may need to be stopped.
During: You'll lie face-down on a procedure table. After sterile preparation and local anesthesia, radiofrequency needles are placed alongside each target nerve using fluoroscopic guidance. Sensory and motor testing confirm accurate placement. Thermal lesions are created at each level. The procedure typically takes 45-75 minutes depending on the number of levels treated.
After: Expect soreness at the treatment sites for 1-2 weeks. A temporary pain increase (neuritis) may occur during the first 1-2 weeks as the nerves respond to treatment. Full pain relief typically develops over 2-4 weeks. You can resume light activities the next day, with return to full activity in about one week.
Benefits
Long-lasting pain relief averaging 9-18 months (some patients 2+ years)
Minimally invasive — no incisions, no general anesthesia
High success rate (70-80%) in properly selected patients
Safely repeatable when nerves regenerate
Significantly reduces or eliminates need for pain medications
Dramatic improvement in mobility and quality of life
Outpatient procedure with quick recovery
Risks and Side Effects
Post-procedure soreness at treatment sites (common, resolves in 1-2 weeks)
Temporary neuritis — burning or increased sensitivity
Small area of skin numbness near treatment site
Infection (very rare with sterile technique)
Unintended nerve injury (exceedingly rare with proper fluoroscopic guidance)
Frequently Asked Questions
How do I know if my lower back pain is from the facet joints?
Facet joint pain typically presents as a deep, aching pain in the lower back that worsens with extension (arching backward), prolonged standing, or twisting. The definitive test is a diagnostic medial branch block — if numbing the nerves to the facet joints significantly reduces your pain, it confirms the facet joints as the source.
How long does pain relief last?
Most patients experience 9-18 months of significant relief. Duration varies based on individual factors including the degree of joint degeneration and overall health. The procedure can be repeated when nerves regenerate and pain returns.
Is this the same as "burning the nerves"?
Yes. Radiofrequency neurotomy is colloquially referred to as "burning the nerves." The radiofrequency energy heats the nerve to create a lesion that prevents pain signal transmission. Despite the term, the heat is precisely controlled and only affects the targeted nerve.
What happens when the nerves grow back?
Medial branch nerves will naturally regenerate over time, which may lead to a gradual return of pain. When this occurs, the procedure can be safely repeated, often with similar or even better results than the initial treatment.
Can I have this done at multiple spinal levels?
Yes. It is common to treat multiple levels in a single session, as facet joint pain often involves more than one spinal level. Your physician will determine the appropriate levels based on your diagnostic block results.
Will I need physical therapy afterward?
Physical therapy is highly recommended after radiofrequency neurotomy. Once pain is reduced, physical therapy can strengthen the supporting muscles of the spine, improve flexibility, and maximize the functional benefits of the procedure.
How does this compare to spinal fusion surgery?
Radiofrequency neurotomy is far less invasive than spinal fusion, with no incisions, no hardware implantation, minimal recovery time, and the ability to be repeated. It is generally preferred as a first-line treatment for facet-mediated pain before considering surgical options.
APSI Wellness — Advanced Pain Solutions & Interventions
5405 DuPont Circle Suite A, Milford, OH 45150 | Phone: (513) 936-3050
https://apsiwellness.com/services/lumbar-facet-radiofrequency-neurotomy