Sperling Medical Group

treating facet joint back pain with mri-guided focused ultrasound

Facet arthritis and back pain

It is estimated that 80% of people experience back pain at some time in their lives. Back pain has many causes: muscle problems or injury, nerve problems, degenerative disc disease, and arthritis. One particular form of arthritis, facet arthritis, affects the joints between the vertebrae that are needed for the spine’s flexibility and stability. For as many as 45% of those with chronic back pain, facet arthritis is the cause. In many cases, a combination of physical therapy exercises, posture awareness, lifestyle changes and anti-inflammatories will be successful in managing the pain. If these strategies prove ineffective, a new noninvasive treatment called MRgFUS may offer relief with minimal to no side effects. However, facet arthritis is often complicated by degenerative disc disease. Proper diagnosis of the pain’s source is necessary in order to determine which treatments are appropriate.

How is facet arthritis diagnosed?

Facet arthritis is diagnosed using imaging. The use of traditional x-rays has been replaced by CT and MRI. Today, advanced MRI that integrates two or more scanning sequences is the best way to detect and diagnose facet arthritis. The Sperling Medical Group offers the most advanced, powerful MRI scans for facet arthritis. Our specialists are best able to interpret what the images reveal. Correct diagnosis is essential, since other types of inflammatory conditions can be mistaken for facet arthritis.

Pain relief through MRI-guided Focused Ultrasound (MRgFUS)

MRI-guided Focused Ultrasound (MRgFUS) is a new noninvasive, radiation-free method of deadening the nerve so it cannot transmit pain signals. Unlike other treatments to deaden the nerve, nothing is inserted into the skin. It can be used for both cervical and lumbar facet pain. It is an alternative to conventional facet pain treatments (see box below). In addition to no needles, steroids, probes or surgery, it has other advantages:

  • More than one facet joint can be treated in a single outpatient session
  • Special MRI software can monitor treatment location and temperature in real time
  • Shorter recovery time
  • Minimal to no side effects

MRgFUS at the Sperling Medical Group

NOTE: Clinical trials involving MRgFUS for back pain are ongoing in the U.S. and abroad. MRgFUS for the treatment of facet pain may not be reimbursed by insurance. However, the Exablate device (Insightec Ltd.) has broad FDA approval for the treatment of soft tissue so physicians can best determine its use on a case by case basis. Sperling Medical Group provides accurate diagnosis of facet pain, and offers MRgFUS to relieve pain when this treatment is appropriate for a patient.

In early clinical studies, MRgFUS as a treatment for facet pain was shown to be safe, free of complications, effective and well tolerated. To learn more about this treatment, contact the Sperling Medical Group.

Conventional Treatments for Facet Pain

  1. Nonsurgical treatments include posture awareness, physical therapy, exercises, anti-inflammatory medications, chiropractic manipulations. May or may not bring long term pain relief. However, often a combination of lifestyle changes, proper exercise and posture, and medication can create significant improvement.
  2. Injections of a combination anesthetic/corticosteroid can be administered, which in many cases brings 3-6 months of relief. It is repeatable. Side effects: 1-2 days of back or neck pain. Complications may occur, such as allergic reaction, infection, worse pain.
  3. Radiofrequency neurotomy uses thermal energy administered by inserting an image-guided radiofrequency probe to deaden the nerve in order to interrupt the pain. It takes up to 2 weeks to be effective, and is repeatable. Effects may last for 6 months to 1 year, in some cases longer. Side effects: 1-2 days of back or neck pain.
  4. Surgical treatment may be offered in cases of extreme or severe, chronic pain in which disc degeneration is also present. The vertebrae are fused so there is no more movement. Side effects or complications occur in less than 20% of cases, with the most common side effect being failure to relieve the pain.

Find out how we can help you

We are at the forefront of noninvasive, technologically-advanced detection and therapies for bone pain due to facet arthritis and may be able to help you reach an end to your pain. Contact the Sperling Medical Group to find out about safe, effective, and complication-free MRgFUS treatment for facet bone pain in our center in Boca Raton, Florida.

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