Frequently Asked Questions.

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They are located on the back of the spine on each side, where one vertebrae overlaps the adjacent vertebrae. They guide and restrict movement of the spine.

You only lose the sensation from the joints, i.e. the pain, which is a sensation you can obviously do without. Occasionally patients develop neck and/or upper trapezius numbness but this tends to be resolved over a couple of months.

All research indicates that these nerves are comparable to the appendix. i.e. the body simply will not miss them.

Because the doctor requires patient input through both of the procedures, only small amounts of anesthetic are used, therefore patients due tend to feel some discomfort during the procedures. It is a simple payoff - short term discomfort for possible long-term elimination of chronic pain.

"These lesions (to the facet joints) cannot be detected with either physical or radiographical examination." BC Office of Health Technology Assessment.

There are currently no radiographical techniques that can "see" whether the facet joints are damaged or not. Commonly patients have clear x-rays, CT scans, MRI scans. Their pain remains unexplained and misunderstood. This lack of "proof" is one of the major obstacles patients have to overcome when searching for treatment. The only technique to conclusively show facet injury are diagnostic nerve blocks.

This depends on a number of factors - the methods used by the treating physician; the number of levels damaged; the patients input. It is very hard to give an average figure, obviously your doctor should discuss this with you before the procedure.

Studies show that the neurotomy procedure is effective for on average 12-14 months, by which time the "burnt" nerves will have regrown. At this point the procedure can be repeated with similar results. How many times it proves necessary for the procedure to be done differs from case to case.

There are no known risks, side effects can include numbness in the area for a period of a few weeks to months and patients report a sensation like sunburn in the area. In almost all cases these are resolved in under three months and often much sooner.

Costs vary greatly from country to country, doctor to doctor. At the time of writing it does not appear to be available free on the NHS in the UK.

Again (sorry) it depends on your insurance, the third party insurance, where you live, litigation status.

Recent advances in the technique now allows for 90%+ accuracy. It does however again depend on the methods used by the treating physician.

If the neurotomy is successful an immediate improvement should be felt. However it may not be apparent as there will be some short-lived postoperative pain which can be hard to distinguish from the pain being treated.

No, patient input is essential to both procedures so the doctor will be talking to you throughout the procedure.

Lots of doctors haven't heard of them, but no the procedures are not new - they have been successfully performed for over a decade.

"The one proven therapy for chronic neck pain is percutaneous radio-frequency neurotomy for the relief of cervical z-joint pain. It affords complete relief of pain in properly diagnosed patients and is the only treatment ever shown to do so." Prof' Nikolai Bogduk.