Why Am I Being Offered this Procedure?

Your doctor suspects that pain in your back, chest, hips, or legs may be caused by irritation of the lumbar or thoracic facet joints.
These small joints connect the vertebrae of the spine and allow movement of the trunk.

When they become damaged or inflamed, they can cause chronic pain.
If previous diagnostic tests (local anesthetic injections) have reduced your pain, radiofrequency denervation may be recommended as a longer-lasting treatment.

What are joint facets?

The facet joints are the contact surfaces between two adjacent vertebrae.
They are innervated by small nerves called medial articular branches, which transmit pain signals to the brain.

What is lumbar or thoracic facet joint denervation?

It is a targeted procedure for treating chronic pain originating from the facet joints.
Using a special needle, controlled heat (approximately 80°C) is applied to the nerves that transmit pain.
This interrupts the pain signals and can lead to lasting relief.

Before the Procedure: What to Know

Inform your pain specialist if:

• You have a fever or feel unwell
• You have allergies to medications, local anesthetics, or contrast agents
• You are taking anticoagulant medications (they may need to be suspended)
• You are pregnant (the procedure uses X-rays and will be postponed)

Preparation:

• Arrange for a companion: you will not be able to drive after the treatment.

How is the Procedure Performed?

• The denervation technique is performed as described by Koetsier et al. (PubMed ID: 39734603).
• For safety, a peripheral venous access will be placed.
• You will lie face down on a special treatment table.
• The skin will be thoroughly disinfected and locally anesthetized.
• Under radiological guidance, the physician will insert a needle near the nerve.
• The needle position will be confirmed through small test stimulations.
• Subsequently, the needle tip will be heated to approximately 80°C for each nerve to be treated.
• After a short observation period, you can return home with a companion.

Duration of the procedure: about 30 minutes.
After an observation period of about 30 minutes, you can go home accompanied.

What Happens Afterwards?

• You may experience a slight increase in pain during the first 2-3 days, up to 2-3 weeks, due to the inflammatory reaction.
• These discomforts usually improve spontaneously or with common pain medications within about 14 days.
• On average, approximately 70-80% of patients report pain improvement similar to that achieved with the diagnostic block.

You will be given a form to fill out to monitor the progress of the pain after the treatment.

How Long Do the Benefits Last?

• Pain relief can last from 6 to 12 months, depending on the natural nerve regeneration.
• If necessary, the procedure can be repeated after a new diagnostic evaluation.

Are there Risks or Side Effects?

The procedure is generally safe. Possible side effects include:

• Pain or discomfort in the treated area in the following days
• Rarely infections, bleeding, or nerve damage. Serious complications are very rare.

Remember:

• Do not drive for 24 hours after the procedure.
• Arrange for a companion for the return home.
• Carefully fill out the form that will be given to you and return it to your pain doctor.