Pain Pathway: RFA is a Solution to Chronic Neck and Back Pain

Chronic neck and back pain can be debilitating!  Even for those of us with a “tough it out” attitude, persistent pain can ruin sleep, hold us back from the activities we enjoy, and even make it difficult to interact with the people we love.  Often, heat packs and Aleve are not enough—fortunately, a minimally invasive procedure called radiofrequency ablation (“RFA”) can alleviate chronic spinal pain.

A significant portion of us with spinal pain have symptoms that are originating from our facet joints.  These are the small joints along the sides of the spine that allow the neck and back to move.  When these joints are damaged or irritated, it can cause a pain cycle that is hard to escape because it’s not possible to stop using your spine like you could an injured hand or sprained ankle.  Even the small, everyday movements like turning your head or bending over involve our facet joints, and these motions can be enough to keep these joints inflamed. 

RFA is an excellent treatment option for back or neck pain coming from the facet joints.  There is no cutting or stitches!  RFA involves inserting a high-tech needle near the nerves that are conducting pain signals from the problematic facet joint.  The needle emits a high-frequency radio wave that disrupts those pain signals.  The pain relief typically lasts for 6 to 12 months, after which the procedure may be repeated. 

More great news: this advanced procedure is covered by health insurance!  Our office works with a variety of PPO plans and it is typically a quick and easy process to get an RFA procedure approved by your insurance company.

Key Facts

• Facet pain is often misdiagnosed! It is common for people to come to me after they have already failed multiple other therapies including conservative management; often they have even had other procedures.
• Conservative treatments can help some people. Physical therapy and chiro, anti-inflammatories, muscle relaxers, yoga, stretching exercises, turmeric, and collagen supplementation are all reasonable options that I sometimes recommend to my patients.  But this approach is not enough for everyone—if the pain persists after a few months of conservative treatment, it is time to look into other options, like RFA. 
• Typically, diagnostic injections will be performed before you proceed with RFA. These injections confirm that the pain is coming from the specific nerves that will be disrupted by the RFA.
• Recovery time is minimal— you can have the procedure on a Friday and then return to work on Monday.
• RFA typically lasts 6 to 8 months (sometimes up to 2 years). When the pain does start to return, you can come back to repeat the procedure (diagnostic injections are not required for repeat procedures).
• To ensure your safety, you must see a physician who is properly qualified and trained to performed RFA. Confirm that your doctor is a Pain Management specialist who completed a Pain Management Fellowship and is Board Certified by the American Board of Medical Specialties (ABMS).  It is essential for this procedure to be performed by a physician with the training and qualifications to ensure that the procedure is both safe and effective.

Many people with spinal pain have a difficult time staying active, or even participating in physical therapy.  Decreasing activity patterns can lead to a slippery slope, progressively weakening the lower back and neck muscles, which can make you feel even worse.  You don’t have to suffer from spinal pain.  You’ve worked hard, and self-care is great care!

Author

Dr. Joseph Enayati Dr. Enayati is a double board-certified interventional pain physician in Beverly Hills and Los Angeles. His focus is on accurate diagnosis and highly tailored patient-specific treatment. When not practicing medicine or attending conferences he can be found running outside, in a spin studio, or exploring the world.