Nobody’s gotten around to calling the Rehabilitation Hospital of the Cape and Islands Zap City, but the folks in Sandwich continue to advance on the cutting edge of their field.
Or, non-cutting edge in this case, since no invasive surgery is involved.
We’re talking about your all-too-common back and neck pain. Four out of five Americans will have significant low back pain sometime in their lives. For some, disabling pain will lead to limitations in daily life, loss of jobs, and serious erosion in quality of life.
The latest innovation at RHCI uses radiofrequency treatments to help those with persistent, chronic back pain resume active lives.
The technique treats a variety of pain conditions, including spinal pain, sciatica, specific peripheral nerve conditions, and neck pain due to whiplash. Most treatments deal with back pain originating in the facet joints of the spinal column. “This is typically diffuse, aching pain in the buttocks, back of the thighs, knees and calves,” says Dr. Jay E. Rosenfeld, a specialist in physical medicine and rehabilitation who is also board-certified in pain management.
In essence, radiofrequency treatment deadens the nerve so that it no longer produces pain. Radiofrequency medial branch ablation is the technical term. Using videofluoroscopy, a type of real-time x-ray that allows the physician to view structures in and around the spine, the physician inserts a needle alongside the targeted nerve. Radiofrequency current heats the nerve until it stops conducting impulses. The 15-minute procedure is done under local anesthetic and produces a 60-70 percent success rate, according to Dr. Rosenfeld.
Developed in the 1980s, the technique gained popularity in the last decade following improvements in the instruments and patient comfort. Often the result is better when combined with a physical therapy program. Relief can last nine to 18 months. When the nerves eventually grow back, the procedure can be repeated.
Not every patient with back pain is a candidate for radiofrequency treatment. Those who’ve had persistent pain affecting quality of life for at least three to six months are considered for the procedure. Since there are many causes of back pain, two nerve blocks are done prior to the procedure to confirm the diagnosis. The evaluation also includes a psychological screening. “People with chronic depression or with poor coping skills tend not to do as well,” Dr. Rosenfeld says.
Radiofrequency is just one modality in the growing field of interventional pain management. At RHCI, rehabilitation physicians have been treating pain since the hospital opened. Managing pain may include medication, physical or occupational therapy, counseling, and physician treatments, such as nerve blocks and spine injections. Acupuncture, trigger point and joint injections may also be performed at selected RHCI outpatient centers.
(For further information or appointments, call 508-833-4160 or visit Physicians at www.rhci.org.)