I went to a pain clinic for an evaluation of my chronic low back pain. It has progressed to the point that I can no longer work and I love my job. I’m a museum curator and I have to stand on my feet all day. I just can’t take it anymore. They mentioned doing some kind of radiofrequency treatment to my nerves to cut the pain. How does this work?

Surgeons commonly use radiofrequency (heat) energy to cut small sensory nerves around the facet (spinal) joints that are causing patients’ low back pain. The procedure is called a radiofrequency denervation (RFD).

patients are carefully selected for this treatment. The pain generating spinal structure must be proven to be the facet joint. Facet joints can be identified as the primary cause of back pain by using fluoroscopic-guided nerve blocks. In this procedure, the surgeon uses special imaging (fluoroscopy) that allows him or her to see inside the body.

A local anesthetic (numbing agent) is injected around the nerve of the suspected facet joint. If more than 50 per cent of the patient’s pain is relieved, the test is considered positive. A positive test means that the facet joint tested is causing the low back pain. The diagnostic facet joint block may be repeated a second time with the same results before patients are treated with radiofrequency denervation.

Once the bothersome facet joint is identified, then radiofrequency denervation can be done. The irritated nerve causing chronic pain signals is burned for 90 seconds at a high temperature (around 175-degrees Fahrenheit). A special probe is used to burn the nerve in three separate places. The result is to completely denervate (cut) the nerve and interrupt pain messages.