Symptoms of facet joint syndrome or axial back pain can be managed and reduced to a great extent without surgical intervention. The degree of relief felt differs from patient to patient and ranges from temporary to significant.
- Physiotherapy that would help support the core muscles and strengthen your back to improve posture.
- Alternating between hot and cold compresses
- NSAID (non-steroidal anti-inflammatory medication, such as ibuprofen) and COX-2 inhibitors (such as Celebrex)
- Lifestyle changes that would help reduce pressure on the muscles at the back
Sometimes, conservative care doesn’t work and the symptoms progress and become chronic.
If this continues for a period of more than six months, surgical intervention or injections may be required to help ease the symptoms. The facet joints connect to the exiting nerve through a small medial branch nerve that connects to the column of muscles in the back. This is the nerve that carries the pain signals from the back to the brain.
A pain management physician can easily diagnose this condition with the help of a series of examinations like a physical check-up, radiographic readings, and finally, a confirmatory facet medial branch block injection. If the pain relief experienced is rated to be higher than 90%, the patient may be recommended a percutaneous radio frequency rhizotomy.
The percutaneous rhizotomy procedure consists of a probe being inserted into the body, guided by an X-ray image, allowing indirect visualization for targeting the medial branch nerve.
Next, the probe is heated to help ablate the small nerve, resulting in instant pain relief.
According to patient reviews, a percutaneous rhizotomy successfully resolves pain related issues in about 70% of patients who opt for it for a year. In some cases, the results may even last up to 5 years. It is up to the patient to choose to be sedated or not, depending on their pain threshold.
When percutaneous radio frequency doesn’t seem to be helping, or the effect fades off too quickly, an endoscopically assisted radio frequency rhizotomy might help. To carry out the procedure, a 7mm tube is inserted into the facet, assisted by X-ray imaging and a working channel endoscope tube attached to an HD camera.
Guided by direct visualization, a physician is able to ablate the medial branch nerve with a radio frequency probe. According to results from clinical literature, around 80% of patients reported a 50% or more reduction in back pain which lasted for up to 5 years. The endoscopic approach has also proven to last longer than radio frequency ablation.