KEY FACTS

• What: Stamford Health is proud to be the first hospital in the country to treat patients with high-intensity focused ultrasound (HIFU), the virtually zero-recovery non-invasive procedure, for lumbar facet join pain.
• Where: Pain Management Center at Stamford Health
• Why it matters:
  
  • For people dealing with chronic back pain, this cutting-edge technology could be life-changing.
  • For the past 30 years or so, radiofrequency ablation has been the best option to provide relief to patients with low back pain due to facet joint origin. With the latest technology of HIFU, the entire process is quicker, safer, and with less pain and discomfort.

For the millions of Americans dealing with back pain, a new cutting-edge technology could bring fast relief – all without a needle. Instead of injections or nerve ablation, doctors can now use high-intensity focused ultrasound (HIFU) to destroy the nerve endings at the root of any arthritic pain in the spine’s joints.

After participating in the clinical trial ahead of its FDA approval, Stamford Health is proud to be the first hospital in the country to treat patients with the virtually zero-recovery non-invasive procedure.

The ins and outs of lumbar facet joint pain

HIFU is suitable for a specific type of chronic lower back pain. Lumbar facet joint pain accounts for 15% to 45% of all lower back pain and occurs when arthritis develops in the joints of the lower spine.

Typically, a patient will feel throbbing, aching, or sharp pain around the center of the lower back when they bend backwards or twist from side to side. Those who suffer from discomfort associated with muscle spasms, degenerative disc disease, or sciatica should consult with their doctors or see a pain physician to determine the most appropriate treatment plan.

Why HIFU is such a gamechanger

For the past 30 years or so, radiofrequency ablation has been the best option to provide relief to patients with low back pain due to facet joint origin. After diagnosing using a nerve block, we lightly sedate the patient and anesthetize the area with a smaller needle. A larger specialized radiofrequency needle with a heater tip is then inserted to create a thermal lesion to destroy the nerve endings. Pain relief is usually experienced several days following the radiofrequency ablation, once the procedural soreness resolves, and lasts around 6 months, sometimes longer.

With the latest technology of HIFU, the entire process is quicker, safer, and with less pain and discomfort. Because we use targeted therapeutic ultrasound without needles to create a thermal lesion, there is no need for numbing or sedation. Many of the patients even feel relief as soon as they leave the procedure suite.

How to know if HIFU is right for you

If you suspect your lower back pain is related to arthritis of your lumbar spine, we accept patients by referral or by calling the Pain Management Center to speak with a team member.

At your appointment, we conduct a thorough evaluation to determine what’s causing the pain. If we suspect it is lumbar facet joint pain, we may initially recommend physical therapy and anti-inflammatory medication.

Prior to performing HIFU, we use fluoroscopy imaging (which is a form of X-ray) to view the joints of the lumbar spine and administer a diagnostic nerve block to ensure the patient receives relief. If so, they are a good candidate for HIFU. We then move forward to perform the HIFU procedure in a non-invasive manner using HIFU under fluoroscopic guidance. This innovative ablation technique takes about 5 to 15 minutes to perform, depending on the number of joints treated, and is about 30% faster than traditional radiofrequency ablation. As the procedure is completely non-invasive, there is no risk of infection or bleeding, and post-procedural discomfort is minimal.

From our participation in the pivotal clinical trial at Stamford Health, as well as additional supporting research, we now know that this treatment is highly effective.

Until the nerve grows back, and it does a little each day, the patient will have relief. This may take 6 to 12 months, and likely longer than the traditional radiofrequency approach, given a far larger ablation lesion that more reliably captures the nerve endings of the facet joint.

The technology is truly remarkable, and we hope that it will be applied to different kinds of pain, such as in the upper back and neck, chest wall, and knees in the future.