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One of the treatment options available
in relieving isolated back and neck pain is radio frequency
lesioning. Though it has been available for over 30 years,
the "why" it works to relieve pain has not always
been understood. Radio frequency lesioning is a technique
of nerve root disruption. And, it is the disrupting of
the nerve root that relieves pain.
Traditional radio frequency lesioning involved placing
a needle very close to the affected nerve. An electrical
current heated the tip of the needle, burning the nerve,
and, in turn, disrupting the pain pathways associated
with it. Originally those utilizing the procedure thought
the "burning of the nerve" disrupted the pain.
But, the burning of which nerves seemed to be in question.
They discovered that burning certain types of nerves actually
could produce pain problems far in excess of the original
problem, while burning other types of nerves caused no
significant complications and worked to relieve the pain.
Through the years, researchers have sought to determine
whether it was the actual burning and destruction of the
nerve that relieved the discomfort or some other mechanism
in the process. They discovered that the electromagnetic
field generated during the delivery of the electrical
current was the primary energy force responsible for relieving
the pain. This discovery meant that it was often not necessary
to actually destroy the nerve to relieve the pain, but
rather to produce a high-energy electromagnetic field
very close to the nerve responsible for the pain. Although
there are many theories on how this actually works, there
is still no definitive answer on the mechanism in action.
Importantly, though, the results of radio frequency lesioning
in relieving isolated back and neck pain have been very
impressive. Additionally, the nerves remain intact using
the 'pulsed' radio frequency technique.
Thermal and Pulsed radio frequency is very effective in
treating isolated back and neck pain. As the pain is isolated,
it does not radiate to other extremities. The isolated
pain that the patient feels is often the result of an
inflammation of the small joints in the spine. A tiny
branch of the nerve root supplies these small jointsfacet
joints which exit the spine at each spinal level. The
nerve root, termed the medial branch nerve, can be selectively
blocked to diagnose whether or not the pain that the patient
is experiencing is arising from the facet joint itself.
If the pain is reduced by blocking the medial branch nerve,
then often radio frequency lesioning will be effective.
By delivering pulsed radio frequency, the pain emanating
from the affected nerve can be reduced for 2 or 3 months,
thermal radiofrequency can extend the relief to 6 to 18
months. |
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