Facet Joint Denervation

Facet Joint Denervation

IMPORTANT: Please inform the Consultant or nurse if you are pregnant or likely to be pregnant as this injection is performed with the aid of x-ray machines. Please also inform the staff if you are allergic to iodine or taking blood thinning medication.

Frequently asked questions and the answers regarding facet joint Radiofrequency Denervation.

WHAT IS RADIOFREQUENCY DENERVATION?
This procedure is performed after you have had a positive result from a diagnostic test injection known as medial branch block or facet joint nerve block. It involves heating the nerve that supplies the facet joint, using a needle connected to the radiofrequency machine. It works best if most of your pain is coming from the facet joints. The heating of the nerves destroys the outer lining of the nerve but it can grow back causing recurrence of pain after a variable period of time.

WHAT IS THE PURPOSE OF THE INJECTION?
It is for relief of facet joint pain.

HOW LONG DOES THE PROCEDURE TAKE?
The actual procedure can take up to an hour.

WILL IT BE PAINFUL?
You may feel some pain/discomfort, twitching or tingling in back during the procedure; this is a good sign. It helps the Doctor to know he has placed the needle where it is needed. Even with a local anaesthetic you may still experience some pain/discomfort at the site of the needle.

WILL I BE PUT OUT FOR THIS PROCEDURE?
No, this injection is performed using a local anaesthetic.

HOW IS THE PROCEDURE PERFORMED?
The procedure is carried out in a treatment room in Theatres. The injection is carried out with the patient lying on their stomach (for treatment to the back). The painful area will then be cleaned with antiseptic solution. A local anaesthetic will be used to numb the area and then the Doctor will direct the needle onto the nerve using X-ray images to assist location.

WHAT SHOULD I EXPECT AFTER THE PROCEDURE?
Immediately after the injection you may have mild discomfort at the site of the injection which can last 48 hours or a week in some patients. Very rarely you may experience a numb leg which lasts only a few hours.

WHAT SHOULD I DO AFTER THE PROCEDURE?

• We advise you NOT TO drive for 24 hours following the procedure, take it easy for the rest of the day and then resume normal activities as tolerated. (Driving on the day may invalidate your car insurance).
• After the procedure try to maintain your own level of activities by keeping mobile (but please take care). Unnecessary rest may worsen stiffness and pain.
• You will receive an appointment for a telephone or clinic follow up after the procedure

BENEFITS
RF procedures can be very effective but they do not work for everyone. Improvement in pain can last up to 18 months. The aim of the procedure is to offer you a window of reduced/minimal pain to help you to participate in core muscle strengthening exercises so that your back pain is better managed in the future.

RISKS
Are there any side effects or risks?

• There can be some temporary pain and bruising at the site of the injection
• Temporary (few hours) leg weakness due to local anaesthetics used.
• For some people the procedure may not work at all.

COMPLICATIONS ARE RARE AND INCLUDE:

• Infection – as with any injection there is a very slight chance of getting an infection where the needle is placed. Sterile techniques are used to minimise risks. However if you experience severe pain or feel unwell contact your GP or Hospital team
• There is an extremely rare chance of nerve injury leading to permanent numbness and weakness of the leg.
• Currently there is no evidence to suggest that Radiofrequency denervation makes spinal pain permanently worse however no injection is without risk.

ALTERNATIVE TREATMENTS
Apart from Radiofrequency denervation, there are other pain relieving/ easing therapies which may help including:

• Pain relieving medicines
• Relaxation
• TENS
• Physiotherapy
• Functional Restoration Program
• Self-management 1:1 Psychology

CONTACTS
Should you require help or advice please contact your Specialist Nurse:

Worcestershire Royal Hospital
Monday – Thursday
Tel: 01905 733313
Answer Phone Service

Kidderminster Treatment Centre
Tel: 01562 512 379

Evesham Community Hospital
Tel: 07436 038 681

Or
Your local GP/Primary Care Unit

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PALS@nhs.net

Opening times:
The PALS telephone lines are open Monday to Thursday from 8.30am to 4.30pm and Friday: 8.30am to 4.00pm. Please be aware that a voicemail service is in use at busy times, but messages will be returned as quickly as possible.

If you are unable to understand this leaflet, please communicate with a member of staff.

Version 1