Lower Back Pain Originating from the Small Joints in the Spine

How do we anesthetize these joints?

The procedure to anesthetize the nerves responsible for sensation in the small joints of the spine is simple, precise, and quick. You will be taken to the interventional procedure room in our clinic, where we will assist you in lying on your stomach on the operating table. Using X-ray guidance, we direct the needles to the nerves around the joints in the spine. After confirming the precise location of the needles, we inject a small amount of local anesthetic and then remove the needles.

After the procedure, you can leave, and we will provide you with a form to track your pain level and improvement during the first six hours. If there is an improvement of more than 50%, we will proceed with the next step, which is performing radiofrequency ablation on a later day.

How do we perform radiofrequency ablation?

Radiofrequency ablation for the lower back joints is done in our clinic under X-ray guidance and takes about 20 minutes. In the interventional procedure room, we assist you in lying on your stomach on the operating table. We disinfect the back area and apply local anesthesia to the skin. Then, under X-ray guidance, we direct special needles that have a tip which can be heated using a radiofrequency device. After confirming the accurate position of the needles under X-ray, we heat the needle tips to 80°C for 90 seconds using the radiofrequency device to destroy the nerves after applying local anesthesia. After the procedure, the nurse will provide post-procedure instructions, and you can leave.

After the procedure, you may experience back pain, but it typically improves within two days, and you can return to your daily activities immediately.

What is the likelihood of pain improvement after radiofrequency ablation? Is the improvement permanent?

Many studies indicate that about 70% of patients who experience significant pain relief after the local anesthesia procedure also show good improvement after radiofrequency ablation. This means there is about a 30% chance that back pain may not improve after radiofrequency ablation, even if pain improved during the first anesthesia procedure. This could be due to the pain source not being from these joints but from another source.

Improvement after radiofrequency ablation can last from 6 to 15 months, but it is not permanent. The pain usually returns within a year because the nerves regenerate, and a repeat radiofrequency procedure may be necessary.

Are there any risks with radiofrequency ablation?

Any medication or procedure carries risks. In our clinic, we use the safest methods for all procedures, and the likelihood of complications after radiofrequency ablation is very low. Potential risks include bleeding, bruising on the back, a side reaction to one of the medications used, nerve damage, or no improvement after the procedure. For pregnant women, there is a risk to the fetus due to the use of X-rays, so we delay the procedure until after delivery.