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Other invasive treatments for back pain
By Mayo Clinic staff
The effectiveness of these other invasive approaches to treating chronic nonspecific low back pain is mixed or unclear.
Radiofrequency neurotomy. This approach, also called radiofrequency lesioning, involves applying heat to certain nerve pathways to block the transmission of pain. To begin the procedure, usually done on an outpatient basis, an area of your skin is numbed. Then your doctor inserts a radiofrequency needle into the area in which he or she wants to block the pain. Your doctor uses a special X-ray machine (fluoroscope) to guide the needle into the precise location. Once your doctor positions the needle, a small electrode is inserted through the needle. To confirm the correct location, your doctor asks if you feel a tingling sensation. An electrical current is then passed through the electrode, heating up and damaging nerve fibers and creating an area of injury (lesion).
Radiofrequency neurotomy isn't a permanent procedure, however. Your nerves will try to grow back, and pain may return in as soon as six months. Short-term side effects may include a burning sensation, pain, numbness and a slight loss of muscle strength. So far, there's conflicting evidence of the effectiveness of the procedure in relieving low back pain originating from the facet joints. And there's limited evidence regarding the effectiveness of relieving pain originating from the disks. Because the evidence is inconclusive, more study is necessary.
Interventional therapy. This treatment refers to injection of anesthetics, steroids or narcotics into soft tissues, joints and other areas in and around your spine. The purpose of such injections is to block nerve conduction, relieving pain. The injection can be in the form of an epidural block, which means the medication is injected into the epidural space (near the spinal cord, but not in the cerebrospinal fluid). Or, the injection may be into a facet joint, which is a joint between two adjacent vertebrae. In some cases, the injection is into the sacroiliac joint, which connects the bottom of the spine with the hip, or into a trigger point, which is a painful knot in a muscle. Reviews of studies have found conflicting evidence regarding the effectiveness of epidural steroid injections in relieving pain in people with chronic low back pain. Studies also haven't shown the effectiveness of facet joint injections in relieving pain in people with chronic low back pain at various intervals of time from the injections.
IDET. Intradiscal electrothermal therapy (IDET), or annuloplasty, is a treatment procedure that involves applying heat to the annulus, the ring of fibrous tissue that surrounds the jelly-like nucleus of the disk. The goal of the procedure is to relieve pain coming from the disk itself. While once a popular treatment option, IDET has fallen out of favor as studies have shown no benefit over placebos.
Invasive treatments for back pain: Pros and cons Spinal fusion
