There was a question about the nature of facet joint pain and the treatment of this chronic pain ...
_Simply, any chronic back pain is caused by facet joints unless we show otherwise. (by anesthetizing the joints and if the pain is still there) This is the most common source of back pain that lasted over 6 months, back pain following a back surgery or following an accident.
in a study that was done around 30 years ago, an irritating chemical has injected into each facet joint of volunteers and asked them about the pain and radiation of the pain. It clearly was shown that the pain of each joint has different radiation. the lower joints radiate into the back of the legs (above the knees) and higher joints radiate toward the lower abdominal area.
If freezing (anesthetizing) the joints takes the pain away, radio-frequency treatment is the Standard of Care. for more information, please check our website.
Answering the question about the test, it is still standard of care to test and see if the nerve that we would target by RFA, is in fact responsible to carry the pain to the brain. a few days after the test, we will call people and let them know about the result.
The RFA test is a standard test in North America which is the best we can use to expect the effect of the RFA in the future. This is not a perfect test since there is a high "false negative" results. From every 2 people who had negative results, one should have been positive. There is many theory about this high false negative, however the end result is the same. We do not count on the negative result of the test and will perform an interview with the patient.
In this test which has two parts, two different local anesthetic would use and would ask the patient to call back on certain intervals and report their back pain. Since the fact about the duration of the local anesthetic in use, is blind to the patient and the doctor who performs the test, neither patient could expect about the duration of pain relief nor the doctor would change anything about the technique of the procedure.
If the reports were compatible With the medication in use, the result considers positive. In this case, there is a good chance that THE RELIF AFTER RFA WOULD LAST OVER ONE YEAR.
Dr. Ramin Safakish, anesthesiologist and pain interventionist, is a full time pain interventionist in Allevio Pain Management.