Radiofrequency lesioning is a common treatment for chronic back and neck pain. However, the side effects of Lumbar Radiofrequency may be worse than the relief it supplies. Let me explain.
Radiofrquency (RF) treatments for low back pain are known by a few different names: radiofrequency, radiofrequency lesioning, radiofrequency ablation, and radiofrequency neurotomy. They all involve placing a needle like electrode into the area where the medial branch nerve is located and then heating that needle tip to ablate (read kill off) that nerve. Since the nerve takes pain signals from the low back facet joints, if the patient has pain coming from these joints, the pain is reduced because there’s no longer a pain pathway from the painful joint to the spinal cord and brain. The good news is that studies have generally shown 6-12 months of low back pain relief. The bad news is that the technology kills a nerve that powers the major stabilizing system in the low back.
The multifidus is probably the most important low back muscle that nobody has ever heard about. It’s a major stabilizer of the spinal bones as they connect one by one. Many studies have shown that weaker multifidus muscles or those that are atrophied (smaller) are associated with low back pain. Why? When these muscles atrophy the spine becomes unstable and more wear and tear happens in the disc, nerve, and joints when the patient is active. This muscle is supplied by the medial branch nerve, the same one that’s killed by RF treatment. In fact, a recent study demonstrated that the effectiveness of RF therapy was directly linked to fully killing off the multifidus muscle.
The upshot? Lumbar Radiofrequency treatment kills off an important low back stabilizing muscle by “nuking” the muscle’s nerve supply. This results in more instability, which likely leads to more wear and tear changes in the low back. So while the patients get temporary relief, low back health as measured by stability, is reduced. To better understand why, read our e-book Orthopedics 2.0. What alternatives are there for painful facet joints in the low back? We’ve seen comparable results by injecting autologous biologics like platelet rich plasma without the need for destabilizing the spine by killing off nerves you need!