After two successful trial injections, Ralph has the RFA procedure. As expected, the procedure has virtually eliminated Ralph’s leg pain. Plus, his back moves better with less pain. His next critical questions for the doctor are: “How long is this going to last doc?” and “If the pain comes back, can I have another one?”
Ralph’s questions are good ones because he knows that the nerve can repair itself. Once the connection between the joint and the brain is reestablished, the pain message will come through again, loud and clear. These questions are answered by the medical evidence. The research results on RFA are promising. At 12 months after the procedure, 60% of the people will have 80% relief. Keep in mind, that these results were produced with a very stringent selection criteria that picked the most likely patients for success. Since Ralph’s doctor was diligent in his screening methods, Ralph is very likely to have good relief for at least a year. If and when the pain comes back, RFA can be repeated without accumulative risks.
Wow, Ralph is so pleased. He asks his doctor one last question: “Will this work for my buddy, Ron, who has neck pain radiating into his arm?” His doctor pauses with a bit of trepidation.
Trepidation is the key word when it comes to treating the cervical spine with RFA. Like the lumbar spine, the cervical facet joints can also cause referred pain. But, unlike lumbar facet pain, the cervical facets refer pain to the arms, shoulders, and head. And, unlike the lumbar spine, the medical evidence for RFA in the cervical spine is unclear. In fact, leading experts have proclaimed that there is no evidence to support the use of RFA in the cervical spine. Despite these words of warning, doctors still try to use RFA in the neck. However, the expectations are lower because the cervical spine facet joint and nerve is a much smaller target than the lumbar spine. The current RFA techniques just might not be accurate enough to hit the smaller target in the neck.
The facet joints are small, but produce a mighty pain that can refer to so many areas of the body. As technology improves, RFA could prove useful for both the cervical and lumbar spine. As technology improves, facet joint pain will one day be curable. For now, Radiofrequency Ablation is the best bet for referred pain that is not responding to non-invasive treatment.
