What is a Radiofrequency Denervation of Lumbar Facet Joints?

Radiofrequency Denervation (also known as Radiofrequency Ablation or Rhizolysis) is a
minimally invasive procedure used to treat chronic lower back pain caused by arthritis or
inflammation in the small joints of the spine, called lumbar facet joints. The procedure
involves using heat generated by radiofrequency energy to interrupt pain signals from the
affected joints by targeting the small nerves (medial branch nerves) that supply them.

What conditions do we offer this for?

This procedure may be suitable if you have:

  • Well-localised chronic lower back pain due to lumbar facet joints
  • One-sided facet joint syndrome, confirmed through previous diagnostic medial branch blocks
  • Postural back pain or stiffness, typically worsened by standing, arching the back, or prolonged sitting

Why is it done?

Radiofrequency Denervation is performed to:

  • Provide longer-term pain relief (often lasting 6–18 months or longer) in cases of well-localised back pain without widespread symptoms
  • Reduce reliance on pain medications
  • Improve spinal mobility and daily functioning
  • Facilitate engagement in physiotherapy and healthy activity
  • This procedure is typically considered only after a positive response to diagnostic medial branch blocks.

What does the procedure involve?

  • You will lie on your front on a specialised X-ray table.
  • The skin over your back is cleaned and numbed with a local anaesthetic.
  • Using X-ray guidance, the clinician inserts fine needles near the target nerves.
  • A small electrical current is used to confirm the correct nerve location — you may briefly feel a tingling sensation.
  • Radiofrequency energy is applied to heat and deactivate the nerve.
  • The procedure typically takes 30–60 minutes and is done as a day case.

Benefits

  • Targeted pain relief lasting 6–18 months or longer
  • Reduced medication use and potential side effects
  • Better posture, sleep, and movement
  • May delay or prevent spinal surgery

Side Effects

Very Common side effects

(may affect more than 1in 10 patients):
  • Pain or bruising at the injection site
  • Temporary increase in back pain (often expected in the early days)
  • Mild numbness or tingling near the injection area

Common side effects

(may affect up to 1in 10 patients):
  • Muscle spasms or cramping
  • Localised swelling or stiffness

Uncommon side effects

(may affect up to 1 in 1,00 patients):
  • Mild skin burn or infection at the needle site
  • Temporary numbness in nearby skin areas

 Rare side effects

(may affect up to 1 in 1,000 patients):
  • Persistent numbness or nerve injury
  • Bleeding or haematoma
  • Allergic reaction to anaesthetic or steroid

Aftercare Advice

  • You will be monitored briefly and can usually go home the same day.
  • Avoid driving for 24 hours.
  • You may experience increased soreness for a few days to weeks — ice packs and simple painkillers can help.
  • Gradually resume normal activities; gentle movement is encouraged.
  • Physiotherapy is often recommended for the best long-term outcomes.

When to Seek Medical Attention

Please attend A&E immediately if you experience:
• Fever, chills, or signs of infection at the injection site
• Sudden chest pain, breathlessness, or dry cough
• New or worsening arm numbness or weakness
• Loss of bladder or bowel control
• Severe or ongoing neck pain not relieved by usual medication