About Facet Joint Injections and Radiofrequency Ablation
Facet joints are small paired joints that link the vertebrae and guide how the spine bends and twists. Like other joints, they can become arthritic or irritated, causing aching pain in the neck or low back that may spread to the shoulders or buttocks.
Because imaging alone cannot prove a facet joint is the cause, the first step is a diagnostic injection. Dr. Chen places a small amount of numbing medication near the medial branch nerves, which carry pain from the facet joints. If your usual pain improves clearly, those joints are likely responsible.
When the diagnosis is confirmed, radiofrequency ablation uses heat to quiet the medial branch nerves for a longer period. Some people instead benefit from a steroid injection into the joint itself. Either way, the aim is to reduce pain so you can return to strengthening and staying active.
What happens during treatment
- 1.
Dr. Chen reviews your symptoms, exam, and imaging to decide whether the facet joints are a likely source of pain.
- 2.
Diagnostic medial branch blocks are done under X-ray guidance, and you record your pain over the next several hours. A second confirming block is often required.
- 3.
If the blocks give strong relief, radiofrequency ablation is scheduled. The skin is numbed, probes are placed under X-ray, and test stimulation confirms a safe position.
- 4.
Each nerve is heated for a short period. You go home the same day with a driver.
Who may be a good candidate
- People with chronic neck or low back pain that is worse with twisting, extending, or standing and has not improved enough with rehab.
- People whose pain stays mostly in the neck or back rather than running down an arm or leg.
- People with facet arthritis on imaging and strong relief from diagnostic blocks.
Recovery
After diagnostic blocks, most people resume normal activity the same day. After radiofrequency ablation, expect soreness for a week or two, and sometimes a sunburn-like feeling over the treated area. Relief usually builds over two to four weeks. A progressive strength program for the trunk and hips helps extend the benefit.
Risks and limits
Common effects include soreness, bruising, and temporary numbness or burning over the treated area. Less often, the treated nerve becomes irritated for several weeks. Infection, bleeding, and nerve root injury are rare. Because nerves regrow, pain can return after months, and the ablation can be repeated. People with pacemakers or other implanted devices need coordination before radiofrequency treatment.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about Facet Treatment
- Why do I need two test blocks before ablation?
- Numbing blocks can give false positive results, so a second confirming block helps make sure the facet joints are truly the source of pain. This improves the chance that ablation will help and avoids unnecessary procedures.
- How long does relief from facet radiofrequency ablation last?
- Relief often lasts many months and sometimes longer, but it varies. As the nerves slowly regrow, pain can return, and the procedure can be repeated if it helped the first time.
- Does facet ablation affect my leg or arm strength?
- No. The medial branch nerves carry pain from the facet joints and help control small back muscles, not the muscles of your arms or legs. Test stimulation confirms a safe position before any heat is applied.