The facet joints are small joints at the back of the spine that guide and limit its motion. Arthritis or injury, for example from a car accident or a fall at work, can make them a lasting source of neck or low back pain.

Diagnosis begins with a medial branch block: a small amount of local anesthetic is placed next to the tiny nerves that carry pain signals from the joint. If the pain improves significantly for several hours, those nerves are likely the source.

In that case, the nerves can be treated with radiofrequency ablation, which uses controlled heat, or cryoablation, which uses extreme cold, to interrupt their pain signals. Both are done through a needle under X-ray (fluoroscopic) guidance, usually take less than an hour, and patients go home the same day.

Relief commonly lasts from six months to a year or longer, and the treatment can be repeated if the nerves regenerate. Your physician will review the benefits and risks with you to decide whether this treatment is appropriate.