Radiofrequency Neurotomy (Ablation) For Sacroiliac Joint Pain

As one ages, arthritis is a frequent unwelcome “friend” and weight bearing joints often experience substantial pain. Two of these joints are the sacroiliac joints which are on both sides of the lower back. They see much less movement than ball and socket joints like the hip, but definitely enough to cause daily pain for people. Radiofrequency ablation (neurotomy) may help affected patients for a long time period with their SI joint pain as an excellent nonsurgical therapy.

With sacroiliac joints, the unfortunate things are that:

1) arthritis in those joints is very common

2) Figuring out the SI joint as the pain generator can be very difficult

3) The problem is difficult to treat whether it’s non-surgical or operative

Similar to the facet joints in the lumbar spine, it can be difficult for a pain doctor to accurately place a needle into the joint. A significant angle may be necessary to achieve placement, and it should always be performed under x-ray guidance. Having a sacroiliac joint injection performed without it entails a high miss rate, upwards of 50%.

The goal with radiofrequency ablation is to “deaden” the tiny nerve endings supplying the SI joint that’s causing a person’s pain. These are not nerves that supply vital sensory or motor functions, but only nerve endings supplying sensation to the joint itself. If those can be eliminated, a person’s pain may be decreased substantially.

Before the radiofrequency treatment, the pain physician performs a diagnostic test with numbing medicine like lidocaine around the small nerve endings to make sur the person’s pain is relieved and the joint is deemed to be the source of pain.

If it works, then the radiofrequency procedure is indicated and the patient’s insurance company usually approves the procedure. The procedure has been shown on average to alleviate pain from six to 18 months, which is more than double the average of a standard cortisone injection.

A radiofrequency ablation is an outpatient procedure. Patients who are on blood thinning medications like Coumadin will need to stop this for at least 5 days or so prior – the physician can give specific time frames.

The therapy often lasts 30-45 minutes and the person has soreness for a few days after. The person may actually get worse for a few weeks as the treatment trauma wears off and the pain relief starts.

At a certain point after the procedure, the nerve endings will grow back and regenerate. This may bring back the pain from before, it may not. If this happens, the procedure may be repeated.

Potential complications from the procedure include injection site pain, numbness over the injection area, muscle spasms causing initially increased pain, infections, or rarely worsened pain.

Want to find out more about our Arizona Pain Management center, then visit Preferred Pain Center’s site on how to choose the best Arizona pain clinic for your needs.