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Radiofrequency Ablation v. Facet Joint Blocks: What’s the Difference?

Sandwiched between every bone in your body is a cartilage joint. It’s what keeps your bones from rubbing up against one another — which is really painful. This includes your knee bones, your hand bones, the bones in your legs and the vertebrae in your back. But your spine has a special type of joint called facet joints. They allow your spine to bend forward and backward, flex side to side and rotate.

When you have osteoarthritis (OA), this degenerative disease can potentially affect all the joints in your body, but it can be especially hard on your facet joints. When they break down, the cushion in the joint wears out and causes increased pain and stiffness.

Unfortunately, a cure for arthritis does not exist, but you can get help with facet joint blocks and radiofrequency ablation. Both treatments involve treating the nerve pain that supplies sensation to the facet joint. But while their goal may be the same, their pain-relieving methods are quite different. One temporarily destroys these small nerves, while one numbs them and reduces swelling in the joint.

Let’s discuss their differences, their similarities and the reasons why a patient could choose one over the other.

What is Radiofrequency Ablation?

Radiofrequency ablation (RFA) stops pain signals from reaching the brain by burning away your nerve endings responsible for that pain. RFA uses radiofrequency waves, similar to microwaves that cook your frozen dinners, to sizzle away targeted nerves. Once those nerve endings no longer exist, they no longer send pain signals to your brain.

RFA treatments may last for a long time. Yes, your nerve endings eventually grow back, but they regenerate quite slowly. Thus, pain relief from RFA lasts for a year on average; however, regeneration time varies from patient to patient. This is why both patients and doctors love RFA — it provides long term pain relief.

What is a Facet Joint Block?

A facet joint block is an injection that contains a powerful anti-inflammatory and numbing medicine or anesthetic. It is placed inside the facet joint capsule containing your nerve root. This treatment is performed by trained pain management specialists using fluoroscopy (X-ray guidance) to ensure they don’t miss the joint.

Depending on your unique treatment plan, you can receive several of these injections every year. Since facet joint blocks often contain a corticosteroid to reduce inflammation, the injections are spread out 3-4 months apart.

How is Ablation Different from Joint Blocks?

While relief to chronic pain is the end goal for both treatments, there are several key differences between them:

  • Ablation stops pain signals by burning the nerve endings but doesn’t address the joint inflammation. A facet joint block reduces nerve inflammation but doesn’t obliterate the disturbed nerve.
  • Ablation lasts for a year on average. A facet joint block lasts for a few months but can be repeated.
  • Ablation can be used in many places on the body where there is an affected sensory nerve. A facet joint block is used exclusively to reduce inflammation in the facet joints along the spine.
  • Ablation does not raise your blood sugar levels. Facet joint blocks can temporarily raise your blood sugar.

It’s easy to see how each treatment has different reasons for when and how it’s used. Because each situation doesn’t have to be an “either-or.”

How Facet Joint Injections and Radiofrequency Ablation Work Together

Before deciding which treatment is right for you, your doctor has to first determine if your joint pain is being caused within a facet joint or by something else entirely. The reality is that back pain can be caused by many factors, and facet joint arthritis is just one of them. Facet joint arthritis will make you feel like you have a very stiff spine and can’t move — to the point that you sometimes have to pivot your entire body to look left and right.

To truly determine if you have facet joint problems, your doctor will most likely suggest a diagnostic facet joint injection first. Since this injection is to diagnose, it won’t contain a corticosteroid. Instead, it will just contain a local anesthetic to numb the nerve for a few hours to determine if the joint arthritis in your spine is causing your back pain.

If you do experience relief, then doctors will definitely know that your pain comes from the facet joint. Your doctor will then decide which is best: A facet joint injection containing an anti-inflammatory or radiofrequency ablation treatment. Or both, if that’s what your doctor determines.

So, if you’re living with arthritis or experiencing back pain, it might be time to speak to Pain Management specialist to determine the root cause. Contact Arthritis Relief Centers today for a consultation!

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