Yes. It is possible to actually destroy or “burn” the nerves that innervate painful facet joints with the Facet Joint Neurotomy/Radiofrequency Ablation procedure. This is an outpatient procedure similar to Facet Joint Injection, but instead of injecting medication to reduce facet joint inflammation, the physician places a needle next to the nerves that innervate the painful facet joints, heats the tip of the needles with radiofrequency energy, and selectively destroys these nerves. A successful outcome following Facet Joint Neurotomy/Radiofrequency Ablation can lead to pain relief that lasts for up to 18 months. Not all patients with neck or back pain are a candidate for this procedure. In fact, patients must have a positive response to a diagnostic nerve block procedure before this next step is performed.
Epidural steroid injections are generally very safe, but there are some rare potential complications. One of the most common risks is for the needle to go too deep and cause a hole in the dura, the tissue that surrounds the spinal cord and nerve roots. When this occurs spinal fluid can leak out through the hole and cause a headache . This headache can be treated with bedrest, or with a blood patch. A blood patch involves drawing some blood from the vein and the injecting it over the hole in the dura. The blood forms a seal over the hole and prevents any further fluid from leaking out.