Why Manage Cervical Facet Pain When You Can Cure it?
If you’re doing an RFA to treat pain from cervical facet syndrome, aren’t you just managing the pain, since the treatment is always temporary? In this day and age of cost containment and reduction of opioids to treat pain, doesn’t it seem that the direction that pain management should go is in the direction of curing pain when possible?
I was a little surprised recently when an orthopedic spine surgeon was looking at my courses (www.endoscopicspineacademy-staging.h1p50byg-liquidwebsites.com) and gave me a call. He asked why I would create a course for such an obscure condition as cervical facet syndrome. I was incredulous since neck pain is considered the fourth leading cause of disability in the world according to WHO! That’s hardly obscure.
That comment from a fellowship-trained spine surgeon really emphasized something I have thought for a long time; it suggested to me that the fellowship spine surgeon is just not trained to look at the “small” causes of pain in the neck. It is also very unlikely that he does his own work to evaluate and block these joints to see how much pain they can cause.
This leaves the evaluation and treatment to the pain management physician. When one considers neck pain, the usual suspects are stenosis, disc herniations and annular tears, and painful facets. In my experience, the facets are the most common cause and most easily treated.
The modern/progressive pain management doctor now has the opportunity to cure cervical facet pain with endoscopic surgery rather than manage it with RFA.