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HPC | Hertfordshire Pain Consultants

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  • I wanted to write a letter to you because I'm so grateful to you and your team at the pain management clinc. After spending over 15 years with the most horrendous headaches and seeing dozens of different doctors and therapists finally you have managed to get them under control. Thanks you for taking the time to genuinely listen to me and my problems. Much appreciated.

    K. R


07803 559 091


Radiofrequency denervation to facet joints

What is Radiofrequency denervation ?

This procedure burns the nerve supplying the facet joint, to provide long lasting relief for those with facet joint arthritis.

Who can have the procedure
  • This procedure is  used for those with a diagnosis of facet joint arthritis based upon good response to medial branch blocks to the facet joints
  • Particularly good in neck pain and low back pain
How many people benefit

Initial response rates are 70%.  In the longer term this procedure works in 50% of patients who continue to experience more than 50% benefit.  For approximately 3 months after the procedure the patient may experience increased pain, during this time extra analgesia may be required and I normally recommend physiotherapy.  The chance of being worse off in the longer term is less than 1%.  Patients may experience long term numbness and occasionally soreness in the back which is usually of no consequence.  Local anaesthetic and steroids are used to help cover post-operative soreness and these may cause headaches for a few days, occasionally associated with temporary weight gain .

Before the procedure
  • Radiofrequency denervation procedures are done as a day case procedure.
  • Do not eat 6 hours before your procedure.
  • You can drink water up to 2 hours prior to the procedure
  • Continue all regular medications except blood thinning medications such as clopidogrel or warfarin.
  • For clopidogrel stop the medication 10 days prior to the procedure
  • For warfarin, stop the medication 5 days prior to the procedure and have a blood test 24 hours prior to the injection at your local anti coagulation clinic
During the procedure
  • During the procedure you will lie on your tummy.
  • You will be offered some sedation to minimise any pain during the procedure.
  • Local anaesthetic is injected into the skin
  • Under x-ray control needles are placed at the back of the spine (approximately 3 per side).
  • The nerves are stimulated using a special machine to locate the medial branch nerve and avoid the nerve that controls the function of your legs.
  • The procedure takes about 60 minutes to perform and does cause some discomfort – but this will be controlled during the procedure.
  • Steroid and local anaesthetic is injected after the denervation procedure to reduce post-operative discomfort.
After the procedure
  • You will be in the recovery room for about 60 minutes
  • You will need someone to drive you home
  • It is common to experience an increase in pain for 2 weeks as the nerves become irritated before dying off.  Take regular pain relief and use cold packs applied to the area in this time.
  • We rarely see any problems with these injections

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