This injection procedure is where a heat lesion is created on certain nerves with the goal of interrupting the pain signals to the brain, thus eliminating the facet or sacroiliac joint pain.
A medial branch neurotomy affects the nerves carrying pain from the facet joints, and a lateral branch neurotomy affects nerves that carry pain from the sacroiliac joints.
These medial or lateral branch nerves do not control any muscles or sensation in the arms or legs so there is no danger of negatively affecting those areas. The medial branch nerves do control small muscles in the neck and mid or low back, but loss of these nerves has not proved harmful.
Success Rates of Radiofrequency Neurotomy for Pain Relief
Before this procedure is undertaken, the joints and branch nerves will have already been proven to be painful by a diagnostic form of spinal injection, and will not have responded to other treatment methods. If effective, the neurotomy should provide facet or sacroiliac joint pain relief lasting at least six to fourteen months and sometimes much longer. After this period of time, however, the nerve will regenerate, and the facet or sacroiliac joint pain may return.
Success rates vary, but typically about 30% to 50% of patients undergoing this procedure will experience significant facet or sacroiliac joint pain relief for as much as two years. Of the remaining patients, about 50% will get some pain relief for a shorter period. Some patients do not experience any relief from facet or sacroiliac joint pain as a result of this procedure.
A facet injection is a minimally invasive procedure that can temporarily relieve neck or back pain caused by inflamed facet joints. The cause of facet joint pain (arthritis, injury, degeneration) is not well understood and can be similar in nature to disc pain. The procedure has two purposes. First, it can be used as a diagnostic test to see if the pain is actually coming from your facet joints. Second, it can be used as a treatment to relieve inflammation and pain caused by various spine conditions. The effects of facet injections tend to be temporary – providing relief for several days or even years. The goal is to reduce pain so that you may resume normal activities and a physical therapy program.
Who is a candidate for facet injection?
If you have neck, arm, low back, or leg pain (sciatica) stemming from inflammation of the facet joints you may benefit from a facet injection. Typically, it is recommended for those who fail to respond to other conservative treatments, such as oral anti-inflammatory medication, rest, back braces or physical therapy. The doctor may wish to perform the injection as a diagnostic test to determine if the facet joint is causing your pain.
Sacroiliac Join Injection
The Sacroiliac joint (SI) is actually fused together by ligaments, and doesn’t move. A SI joint injection is performed if your doctor suspects that your pain may be originating joint injection.
This is an injection of local anesthetic (like Novocain) and anti-inflammatory steroid (not muscle building) into and around the Sacroiliac Joint in your pelvis. The SI joint is actually not like any other joint. Other joints in your body are pivot points that allow movement. The SI joint is a non-moveable joint that is held together by very strong ligaments and muscles. The local anesthetic numbs the joint and also numbs and relaxes the muscles around the joint, which can result in sustained pain relief. If you achieve partial sustained relief following the first SI joint injection, then a series of injections may give you even a greater degree of sustained relief.
The procedure will take about 10-15 minutes.