Thoracic Facet Radiofrequency Ablation (RFA)

Facet joints are small joints located between each vertebra of the spine. In the thoracic spine (mid-back), these joints help stabilize the spine and allow for controlled motion. When these joints become arthritic or irritated, they can cause chronic mid-back pain.

Radiofrequency ablation (RFA) is a procedure that uses heat generated by radio waves to disrupt the function of specific spinal nerves that carry pain signals from the facet joints. In thoracic RFA, these nerves (medial branches) are targeted in the thoracic region of the spine to relieve chronic facet joint pain.

• Chronic thoracic back pain lasting more than 3–6 months
• Pain confirmed to originate from the thoracic facet joints
• Temporary pain relief after diagnostic medial branch blocks
• Pain not responsive to physical therapy or medication alone

• Fasting: You may be asked not to eat or drink for 6–8 hours before the procedure.
• Medications: Discuss all medications with your provider, especially blood thinners.
• Transportation: Arrange for someone to drive you home. Do not drive yourself.

• You will lie face down on the procedure table.
• The area is cleaned and numbed with local anesthetic.
• Under fluoroscopy (live X-ray) guidance, small needles are placed near the medial branch nerves.
• A small electrical current may be used to confirm proper placement.
• Once confirmed, radiofrequency energy is applied to heat and deactivate the nerve.
• The procedure usually takes 30–45 minutes, depending on the number of levels treated.

What to Expect:

• Soreness or mild burning at the injection sites for a few days is normal.
• Pain relief may take 1–3 weeks to begin as the nerve slowly stops transmitting pain signals.
• Relief can last 6 months to over a year, depending on individual response and whether nerves regenerate.

Activity:

• Rest for the remainder of the day.
• Resume light activity the next day.
• Avoid heavy lifting or strenuous activity for 1–2 days.

• Temporary increased pain or soreness
• Muscle spasms
• Bruising or bleeding at the injection site
• Numbness or tingling in the area
• Infection (rare)
• Nerve injury (very rare)

• Fever or chills
• Redness, swelling, or drainage from the injection site
• New or worsening numbness, weakness, or severe pain
• Difficulty breathing (rare, if high thoracic levels are affected)

• Pain relief usually lasts 6 to 12 months.
• The procedure can be repeated if the pain returns after nerve regeneration.