• Mark J. Downey, MD & Alex Cotter, MD
    10 Old Montgomery Hwy #200. Homewood, AL 35209
    Appointments & Referrals: (205) 271-6511

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Radiofrequency Ablation

The facet joints are often the underlying source of chronic neck and lower back pain. When steroid injections within the joints are ineffective long term or the patient has a steroid contraindication, RFA could be the solution.

This safe fluoroscopic (X-ray guided) procedure is performed in SpineGroup Alabama’s office procedure suite under moderate IV sedation. The basis of performing this procedure stems from potential long-term relief that can be gained by causing focal injury to a sensory nerve branch responsible for innervating the arthritic joint. By delivering a 90 second radiofrequency signal to the small sensory nerve, focal nerve injury is caused affecting its ability to send a pain signal from that desired level. Although the joint will still have arthritis and degenerative changes, your pain level will be significantly improved by essentially “numbing” the joint.

In most cases, you will be scheduled for 2 diagnostic nonsteroid lidocaine blocks in our office to confirm the proper levels necessary for RFA. Insurance requires these diagnostic blocks before an RFA can be performed. By injecting a small amount of lidocaine and marcaine at the desired levels, there is immediate pain relief often lasting for several hours following the procedure.

If your diagnostic blocks are positive for pain relief >70%, then you are scheduled to return for the RFA. In all cases, you will be sedated and monitored safely by our anesthesia team. The diagnostic blocks generally take about 10 minutes to perform. The RFA usually takes 15-20 minutes, but can take up to 30 minutes depending on the degree of spurring and arthritis present affecting needle placement.

Although the diagnostic blocks can be performed bilaterally at the desired levels, the RFA is a unilateral (one-sided) procedure in most cases. You can easily schedule a follow up RFA on the other side within the next week or two if necessary.

Dr. Downey and Dr. Cotter have been performing this procedure, in office, for several years now and has been very pleased with the results. Call to schedule an office consult and see if you are a candidate for this simple, safe treatment option.


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Spine Group Alabama specializes in the treatment of back pain, neck pain, herniated discs, and all types of ligament strain related to the neck and low back. Spine Group Alabama is referred  back and neck pain patients from across Alabama, including Birmingham, Tuscaloosa, Auburn, Huntsville and Montgomery.

Office Hours:
Monday - Thursday: 8am - 4:30pm
Friday: 8am - 2:30pm
Saturday/Sunday: Closed
(205) 271-6511

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