Introduction

Denervation means an interruption of the pain-carrying nerves, in this case the ones supplying the facet joints in your back. It is done using radiofrequency (RF) lesioning. This is a safe, proven means of interrupting pain signals. RF current is used to heat up a small volume of nerve tissue, thereby interrupting pain signals from that specific area. Clinical data shows that RF lesioning can effectively provide lasting pain relief.

Treatments & Side Effects

RF lesioning is performed by the specialist in an operating room setting. Both local anaesthesia and a mild sedative may be used to reduce any discomfort during the procedure. You will need to be awake and alert during both the sensory and motor stimulation process to aid in properly pinpointing the placement of the lesioning electrode.

Please fast (no food or drink) for 4 hours prior to this procedure.

During the procedure you will be lying on your stomach. After the local anaesthesia has been administered, the doctor will insert a small needle into the general area where you are experiencing pain. Under X-ray guidance, he will then guide the needle to the target area. A microelectrode is then inserted through the needle to begin the stimulation process. During this process, you will be asked by your doctor if you are able to feel a tingling sensation. The object of the stimulation process is to help your doctor determine if the electrode is in the optimal area for treatment, thus producing the most relief.

Once the needle and electrode placement is verified, treatment is ready to begin. A small RF current will travel through the electrode into the surrounding tissue, causing the tissue to heat and eliminate the pain pathways. You should alert your doctor if at any time during the procedure you experience any discomfort.

After the procedure you may experience some soft tissue discomfort at the needle placement sites. Like other soft tissue wounds, the discomfort will subside over several days. Food and liquid consumption can usually be resumed soon after the procedure.


RF treatment usually blocks pain signals for a prolonged period of time. However, the human body may regenerate pain pathways over time. It is not unusual that the procedure may need to be repeated.

RF treatment will not limit your day-to-day activities. You should be able to resume your normal activities, including work, as soon as you feel able. However, any pre-existing physical restrictions you had prior to the procedure may still remain.

Overall about 90% of patients will experience an improvement with the loss of approximately 50% of their pain.

You will be in the Clinic for approximately 1—2 hours in total

An appointment will be made for follow up.

Useful Addresses

If you have any questions please ask a member of the nursing staff who will be happy to help you. You may find other useful information at:
www.backcare.org.uk or www.britishpainsociety.org

Frequently Asked Questions

WHAT IS CORTISONE?

Cortisone is a powerful anti-inflammatory medicine which reduces inflammation around the nerve tissue and can break into the cycle of entrapment and swelling. This reduces pain, numbness, weakness.

IS THERE A LIMIT TO THE NUMBER OF INJECTIONS YOU CAN HAVE?

In any particular place in the body there is a natural limit of three injections in a 6 week period. Further injections are allowed in other places and at other times especially if they are effective. Your specialist will guide you.

WHAT COMPLICATIONS MAY OCCUR?

Hot flushes for 2 days.

Allergic reaction to any injection may occur in 1 in 7000 cases. This may just be a rash or a life threatening reaction. These will usually occur immediately and will be treated immediately. Most reactions are treated and cause no permanent harm.

Bleeding - Epidural Haematoma and resulting nerve damage is a very rare (1 in 7000) complication after a bleed around the nerves. This usually requires surgery to remedy.

Infection – Very rarely (1 in 7000). An Epidural Abscess or infection in other tissues can occur rarely. You should watch for signs of fever, redness, swelling and increasing pain. This can be treated with antibiotics or even surgery.

Spinal Fluid Leak – This causes a very bad headache, nausea/vomiting which goes away on lying down. This rarely lasts more than a few days.