Chronic lumber facet joint pain is defined according to international association of study of pain (IASP)as multifactorial phenomenon of pain that persist more than 3 months after an injury and /or beyond the usual course of an acute lumber facet pain or a reasonable time for a comparable injury to heal . lumber facet joint degeneration (LRFJ) is the 1st source of chronic low back pain with an incidence of 15% t o 45 % among patients with low back pain . the spinal facet joint has an abundant nerve supply ; therefore, pain can be caused by arthritic change, degenerative change, inflammation, and injury . Degeneration of all LFJs (lumbar facet joints) was diagnosed using magnetic resonance image (MRI) , the most sensitive and diagnostic tool. Thus, hypertrophy, degeneration, and the accumulation of fluid within the joints are signs of LFJ degeneration it was found in all treated LFJs . facet joint pain management can be achieved using medical therapy or facet joint therapeutic interventions, ultrasound guided injection,or fluoroscopically guided facet joint injection (FJI) , medial branch block (MBB) , or radiofrequency ablation . Radiofrequency is a minimally invasive procedure and is operated under light intravenous sedation or local anesthesia when necessary. Radiofrequency energy is delivered to the target nerves through an insulated needle , and this energy heats and denatures the nerve for the purpose of pain relief . The radiofrequency techniques include, thermal, and cooled radiofrequency . thermal radiofrequency (TRFA) uses more energy and higher temperature compared with cooled radiofrequency , cooled radiofrequency ablation (CRFA) is a newer technique, and may have some theoretical advantages over traditional radiofrequency whereas , cooled radiofrequency adopts internally probes to increase lesion size , and it can increase the chance of complete denervation . based on heat neurotomy (60°C (celsius) vs. 80°C in TRFA) with the resulting ablative area twice as long and extending distally from the tip of the electrode.
Age range
30 Years – 70 Years
Sex
ALL
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Change in pain intensity
Timeframe: NRS will be detected and recorded immediately 2 hours post intervention and then at 1 week , 1 month , 3 months, and 6 months after intervention .