More than 80 percent of the population will experience low back pain during his/her life with recurrence quite common. One of the causes for such pain is spinal arthritis. Osteoarthritis, commonly thought of as affecting the peripheral joints (i.e. hips or knees), can indeed affect the spine. Management of the pain from spinal arthritis continues to be a challenge for physicians.
The zygapophysial joints, also known as facet joints, have been identified as a source of pain in up to 45 percent of patients with chronic low back pain. Optimal alignment of these joints permits freedom of movement as you bend forward and back. The joints typically fit together nicely and glide smoothly without friction or pressure. Over time, however, the cartilage, or cushion, that protects the joint surfaces start to wear away. This can lead to inflammation, pain and limited joint motion.
Patients with pain coming from arthritis of the lumbar spine (low back) may experience pain in the low back, but also in the buttocks, hips and/or thighs. One may experience pain and/or stiffness when waking in the morning, with standing or walking, and find relief with sitting. The pain can affect everyday activities and may limit one’s quality of life.
Treatment is generally non-surgical and may include physical therapy, chiropractic care, acupuncture, homeopathic options and/or medications. Yet, when patients fail such treatments, where does one turn? Radiofrequency ablation (RFA) is a non-surgical approach to help patients find relief from this debilitating pain.
RFA is a minimally invasive spinal procedure that has been beneficial to treat chronic pain from arthritic facet joints of the spine. Performed under fluoroscopy, which is live x-ray, radio waves are used to heat up and lesion specific nerves, with the goal of interrupting the conduction of pain from the arthritic joints to the spine.
The procedure is performed in an outpatient setting and performed with local anesthesia (numbing medicine). Benefit from the procedure may take a few weeks for full results, with such benefit lasting 6-12 months. After this period of time, the nerves may regenerate. The procedure can be repeated every 6 months if necessary.
Prior to performing such procedure, your physician will need to evaluate you to determine if the pain is coming from arthritis. The doctor will obtain a history regarding your pain and perform a physical examination. The doctor may also order imaging, such as x-rays and even a magnetic resonance imaging (MRI) study or computed tomography (CT) scan to further assess your anatomy. If your doctor finds that your pain is likely coming from your arthritic facet joints, a diagnostic procedure is then performed to confirm such and determine if you would be a candidate for the RFA.
Dr. Stacey Franz is an interventional physiatrist who is double-board certified in Physical Medicine & Rehabilitation and Sports Medicine. She is Medical Director at NorthEast Spine and Sports Medicine, a practice that offers a multi-disciplinary approach to treating your pain. To schedule an appointment in our Aberdeen office, please call 732-997-4988. They also have locations in Point Pleasant, Jackson, Barnegat and Manchester. Please visit our website at www.northeastspineandsports.com for further information.
