Successful Management of Long Standing Low Back Pain with Radiofrequency Ablation Treatment

A 54-year-old lady with long-standing low back pain achieved excellent and lasting relief following bilateral lumbar radiofrequency denervation performed by Dr. Krishna at Pain Spa, Bristol.

Introduction

A 54-year-old lady presented with persistent low back pain lasting more than ten years following a previous injury. Her pain was al across the lower back with radiation to the buttocks and hamstrings, but not below the knees. It was aggravated by physical activity, particularly during exercise, and worsened with prolonged sitting, standing, or lying in one position. Rest did not provide relief, and sleep was often disturbed by pain. There were no bladder or bowel symptoms.

Case Summary

An MRI scan of the lumbar spine revealed anterolisthesis at L4-L5 and degenerative changes in the lumbar facet joints, consistent with mechanical facet-mediated pain. The patient had a background history of widespread osteoarthritis and had not benefited from physiotherapy or spinal surgical consultations, where non-surgical management was advised.

On examination, there was restriction of lumbar extension and significant tenderness over the facet joints bilaterally. After discussing various options, Dr. Krishna performed diagnostic medial branch blocks, which provided excellent short-term relief, confirming the facet joints as the source of pain.

Treatment Details

The patient subsequently underwent bilateral lumbar radiofrequency denervation under fluoroscopic guidance by Dr. Krishna. This advanced interventional procedure involved precise needle placement and controlled thermal lesioning of the medial branch nerves supplying the affected facet joints.

Outcome

At the three-month review, the patient reported marked improvement in both pain and mobility. This benefit was maintained at 12 and 24 months, with pain relief lasting more than two years. She regained her functional ability and reported a greatly improved quality of life. A rehabilitative exercise programme focused on core strengthening was recommended for ongoing management.

Discussion / Expert Insight

Radiofrequency denervation is a technically demanding intervention that requires a high level of expertise and precision. Correct needle localisation and accurate targeting of the medial branch nerves are vital for a successful outcome. Dr. Krishna is a recognised expert in interventional pain management, with extensive experience performing complex radiofrequency procedures under fluoroscopic  guidance, ensuring optimal results for his patients.

For more information about radiofrequency treatment or to find out if this procedure may be suitable for you, please visit www.painspa.co.uk or email us at clinic@painspa.co.uk for further details.