Thoracic Medial Branch Blocks and Cooled RF (Coolief)
The role of thoracic facet joints in chronic back pain has received very little attention, as compared to lumbar and cervical facet joints. Thoracic spinal pain can be as chronic and disabling as neck and low back pain, even though it is less common. Linton et al estimated the prevalence of all spinal pain in the general population as 66%, with 15% reporting thoracic pain, 44% reporting neck pain and 56% reporting low back pain.
Thoracic facet joint syndrome was not described until 1987. In 1994, Dreyfuss et al and Fukui et al in 1997 described thoracic zygapophysial joint pain patterns. Manchikanti et al evaluated thoracic facet joints as potential sources of chronic pain.
Thoracic intra-articular injections have been used to describe the facet joint referral pain patterns, whereas medial branch blocks have been used to determine the prevalence of thoracic facet joint pain as well as for therapeutic purposes. Radiofrequency neurotomy also has been used to manage thoracic facet joint pain.