Thoracic Facet And Medial Branch Neurotomy
What are thoracic facet joints and medial nerves?
Facet joints are small joints between the spinal bones (vertebrae) that are supplied by the medial nerves. These joints can be injured and become the source of persistent upper back pain.
You might have mid back pain due to wear and tear of the facet joints which is called facet joint arthropathy. The pain is usually described as a dull aching discomfort. Injecting the facet joints can help relieve the pain and is, in addition, a useful diagnostic tool to confirm thoracic facet joint arthropathy.
What is the aim of the facet joint injection?
The aim of the injection is to instill local anesthetic either into the facet joint or close to the nerve that supplies the joint. It can be used either as a diagnostic tool to confirm whether facet joint is the cause of back pain, or as a treatment for the pain, and could be repeated when necessary.
How are these injections performed?
At Atlas Pain Care, Coimbatore, it is performed under x ray/ultrasound guidance on a day surgery basis. You will be asked to lie face down on couch and the area to be injected is cleaned with antiseptic solution and a fine needle is inserted into the facet joint or close to the nerve supplying the joint, and the medicine is injected.
How long will the pain relief last for?
Pain relief varies for each individual. The pain may be
- Relieved significantly and for longer periods
- Reduced for several weeks and then return, but not with the same severity as before.
- Reduced for several weeks but the original pain recurs.
When the facet joint is not the source, the pain relief may be unsatisfactory.
What is medial branch radiofrequency neurotomy?
If your pain returns after a period of relief then the medial nerves may be heated upto 70-80 degree Celsius using special radiofrequency needles. This will give a long-term pain relief.
What are the risks and complications of this treatment?
Soreness and bruising can happen at the injection site. This usually settles in few days. Other complications like bleeding and infection are not common. Please read our FAQ section to know more about the do's and don'ts prior to and after the procedure.