Disc pain is one of the most common forms of back pain across the world. Disc Denervation is a pain procedure used to treat chronic disc related pain. Pain occurs when discs compress or irritate local spinal nerves. Disc denervation, in a sense, deactivates the irritate nerves and blocks the affected nerves from sending anymore messages of pain. This is accomplished when the messages are heated and destroyed with radiofrequency. The heat generated from the radiofrequency modifies certain nerve fibers and blocks the perception of pain that is received by the brain.
Radiofrequency denervation is often more effective than other treatments, precisely, because of the temperature manipulation of irritated nerves (Ahmet 2006). Neuropeptides, or pain sensing chemicals along the periphery, or edges, of your nerves control both inflammation and the sense of pain. Nerves connected to the spinal cord eventually send a signal of pain to the brain. When the pain-sensing nerves are identified, successful pain relief can occur after they are denervated (Koscharskyy 2007).
Anatomy:
Spinal discs are designed to be soft and provide support, but they have a tendency to herniate backwards causing irritation to the adjacent nerves. Disc disease is one of the most common causes of chronic neck or back pain and accounts for approximately 10% of all lower back pain complaints. Disc disease can be acute, caused by herniation, trauma, or more commonly, degenerative disc disease. Degenerative disc disease causes as thinning and degeneration of the discs over time and can lead to spinal dysfunction, nerve impingement, or peripheral nerve irritation. Disc denervation is considered for most patients who have disabling chronic pain, especially when due to one of the aforementioned conditions and when conservative treatments have failed. Disc denervation is a common treatment for people with chronic neck and back pain.
Procedure:
Using a small thin needle, your physician will administer a local anesthetic to numb your skin and subcutaneous tissue (tissue just below the surface of your skin). A radiofrequency needle is advanced under fluoroscopy or real-time x-ray to the source of pain. Electrical stimulation is initiated through the needle and your disc pain is duplicated. When the correct nerves have been identified, the nerve supply to the disc is denervated with the radiofrequency. This procedure destroys pain-causing nerves and lessens the effects of pain on the surrounding area. The entire procedure lasts about an hour, and the site receives a small bandage after the treatment is complete.
Benefits
Disc denervation is a minimally invasive procedure which may provide significant relief. No hospitalization is required and the procedure is performed with local anesthesia and, sometimes, sedation. There is, often, some post-procedure discomfort, but you will be able to quickly resume your normal activities. Disc denervation is that it can be controlled, minimizing the risk of damaging adjacent nerves. If pain reoccurs, the procedure can be repeated.
Risks
As with all procedures, disc denervation carries some risk. However, that risk is quite rare. The complication rate per patient is 1.0% (Kornick 2004). There is a small risk of bleeding, infection, or nerve damage. The most common complaint is pain at the procedure site after the local anesthetic has worn off, but this tends to go away within 24 hours.
Outcomes
Disc denervation has been used as pain management for over two decades. In a 2007 study, it was revealed that more than half the patients treated with radiofrequency denervation had moderate to excellent pain relief lasting up to a year (Gofeld 2007). The best results were seen in patients with low back pain, who found that they were able to return to their normal daily activities very shortly after treatment (can Kleef 1999). If you are suffering from chronic back or neck pain that has been resistant to other treatments, contact Arkansas Pain Specialists today to see if you can benefit from this innovative treatment.
Journal Articles
- Principles and Uses of Radiofrequency Nerve Lesioning in Chronic Pain Control Ahmet H. Ozturk, MD CHH Pain Management Clinic
Complications of lumbar facet radiofrequency denervation. Kornick C; Kramarich SS; Lamer TJ; Todd Sitzman B Department of Anesthesiology, Division of Pain Management, Mayo Clinic, Jacksonville, Arkansas, USA. Spine. 2004; 29(12):1352-4 (ISSN: 1528-1159) - Lumbar discogenic pain. Disk degeneration and minimally invasive interventional therapies Kosharskyy B, Rozen D. Anasthesiol Intensivmed Notfallmed Schmerzther. 2007 Apr;42(4):262-7
- Radiofrequency denervation of the lumbar zygapophysial joints: 10-year prospective clinical audit. Gofeld M, Jitendra J, Faclier G. Pain Physician. 2007 Mar;10(2):291-300
- A randomized controlled trial of radiofrequency denervation of the ramus communicans nerve for chronic discogenic low back pain. Oh WS, Shim JC. Clin J Pain. 2004 Jan-Feb;20(1):55-60
- Randomized trial of radiofrequency lumbar facet denervation for chronic low back pain. van Kleef M, Barendse GA, Kessels A, Voets HM, Weber WE, de Lange S. Spine. 1999 Sep 15;24(18):1937-42