What are thoracic facet joints?

Facet joints connect the vertebrae, the bones of the spine. They help guide your spine when you move. The middle area of the spine is called the thoracic region. It contains twelve vertebrae.

Facet joints are found on both sides of the spine. Each is about the size of a thumbnail. Cervical faced joints are named for the vertebrae they connect and the side of the spine where they are found. The left T3-4 facet joint, for example joins the 3rd and 4th vertebrae on the left side.

What is thoracic facet joint pain?

You may feel pain if a thoracic facet joint is injured. Sometimes it feels like muscle tension. Other times it can be severe pain. The cartilage inside the joint may be injured. Other times only connecting ligaments surrounding the joint are injured. Facet pain also depends on which facet joint is affected. Thoracic facet joint pain can occur in your upper back down to your hips.

How do I know if I have thoracic facet pain?

If you have pain in one or more of these areas when you bend your back, and at last longer than 2 months, you may have thoracic facet pain. Common tests such as x-rays or MRIs may not always show if a facet joint is causing pain. The best way to diagnose facet pain is block the pain signal in a medial branch nerve with a local anesthetic.

What is Thoracic RFA?

RFA uses radiofrequency energy to disrupt nerve function. When this is done to a thoracic medial branch nerve, the nerve can no longer transmit pain signals from an injured facet joint.

What happens during an RFA?

An IV may be inserted to administrator intravenous medications to help your lax. A local anesthetic will be used to numb your skin. Fluoroscopy, a type of x-ray, will be used to insure the safe and proper position of the needle. The doctor will then check that the needle is in the proper position by the stimulating nerve. This may cause muscle twitching and provoke some of your pain. With the needle in the correct position, the area will be numbed. Your doctor will then use radiofrequency energy to disrupt the medial branch nerve. This is often repeated at more than one level of the spine.

What happens after a RFA?

You will be monitored for up to 30 minutes after the RFA. When you are ready to leave the staff will give you the discharge instructions. You may feel sore for one to four days. This is normal, and may be caused by muscle and nerve irritation.  Your back may feel numb, weak, or itchy, for a couple of weeks. Be patient, as  full pain relief normally yikes two to three weeks but can take as long as eight weeks.

How long can I expect pain relief?

Nerves regenerate after an RFA, but how long this takes varies.  Your pain may or may not return when the nerves regenerate.  If it does, another RFA can be done. This article is for general education only. Specific questions or concerns should always be directed to your doctor. Your doctor can explain possible risks or side effects. 

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