Radiofrequency Ablation (RFA): Life without pain with facet syndrome

Chronic, debilitating lower back or neck pain that worsens with back extension, torso rotation, or prolonged standing is often a sign of facet syndrome (arthrosis of the small joints of the spine). Patients take handfuls of painkillers for years, which only destroy the stomach but do not solve the problem.

If massages, ointments, and pills no longer help, and major spinal surgery is not indicated, specialists at St. Luke’s Clinic offer a modern alternative — radiofrequency ablation (RFA) or denervation. This is a unique, minimally invasive procedure that literally “turns off” the nerve that transmits pain signals to the brain.

What is facet syndrome and why does the back hurt?

Our spine consists not only of discs but also of small facet joints that connect the vertebrae. With age, due to heavy physical labor or injuries, the cartilage in these joints wears out, and inflammation (arthrosis) occurs. Each small joint has its own small nerve (medial branch). When the joint becomes inflamed, this nerve begins to continuously send pain signals to the brain. The person feels stiffness and finds it difficult to even simply straighten their back after sitting.

How does radiofrequency ablation (RFA) work?

RFA is not a surgical operation; there is no scalpel, incisions, or stitches. The procedure is performed using a thin needle-electrode.

1. The doctor inserts the needle precisely to the small nerve responsible for pain in the worn joint.
2. High-frequency current (radio wave) is supplied through the needle, which safely heats the tip of the electrode.
3. Under the influence of temperature, the nerve ending is “cauterized” (coagulated) and permanently loses its ability to conduct pain impulses.
4. Result: the joint remains in place, it may be worn, but you no longer feel pain! This is similar to how a dentist removes a nerve from a diseased tooth so that it no longer bothers you.

How is the procedure performed at St. Luke’s Clinic?

We adhere to European pain management protocols, ensuring maximum accuracy and safety.

• Test Block (Diagnosis): First, the doctor performs a regular injection with an anesthetic near the suspicious nerve. If your pain disappears by 80-100% for several hours after this, it means the “culprit” has been correctly identified, and RFA can be performed.
• Jeweler’s precision: The radiofrequency ablation itself is performed in the operating room under continuous X-ray control (C-arm). The doctor sees the needle’s advancement on the monitor with millimeter precision. This completely eliminates the risk of damaging the spinal cord or motor nerves (legs will not be affected).
• No general anesthesia: The procedure is performed under high-quality local anesthesia. You will be conscious and able to communicate with the doctor. The entire process takes about 30–40 minutes.

Advantages of the method and rehabilitation

Radiofrequency denervation of facet joints is a “one-day” procedure that has a number of undeniable advantages:

• Quick return home: Already 1-2 hours after the procedure, after resting in a comfortable ward, you will be able to leave the clinic independently and go home.
• Long-lasting effect: The analgesic effect of RFA lasts from 6 months to several years (until the nerve fiber recovers naturally). If the pain ever returns, the procedure can be safely repeated.
• No scars: Only a trace from the needle injection remains on the back, covered with a plaster.
• No long sick leaves: You will be able to return to your usual work in 1-2 days. The only restriction is to avoid heavy physical exertion and thermal procedures (sauna, hot bath) for the first few weeks.

Don’t let pain control your life and limit your movement! Schedule a consultation with pain management specialists (vertebrologists) at St. Luke’s Clinic. Feel the freedom of movement today!