Chronic back pain is one of the most common reasons people in Nassau and Suffolk counties seek medical care. For many patients, nerve-related pain from the facet joints or other spinal structures does not respond to medications and physical therapy alone. At MK Spine & Joint Rehab (Marvin Kalter Spine & Joint, P.C.), our Garden City and Hauppauge teams evaluate each patient individually and offer a range of minimally invasive, image-guided procedures — including radiofrequency ablation (RFA) and facet denervation — alongside rehabilitation and medication management to reduce pain and restore function.
Understanding Facet Joint Pain and When RFA Is Considered
The facet joints are small stabilizing joints at the back of the spine that can become painful from arthritis, injury, or repetitive strain. Facet-mediated pain is often localized to the low back and may radiate to the buttocks or thighs without following a specific nerve-root pattern.
How clinicians identify facet joint pain
Diagnosis begins with a careful clinical history and exam, and often includes imaging such as MRI or CT. When facet pain is suspected, diagnostic medial branch blocks (small injections of local anesthetic to the nerves supplying the facet joint) can confirm the pain source by providing temporary relief. These targeted diagnostic tools guide treatment decisions and help avoid unnecessary interventions.
What Is Radiofrequency Ablation (RFA) / Facet Denervation?
Radiofrequency ablation, sometimes called radiofrequency neurotomy or facet denervation, uses a controlled electrical current to create a small lesion on the sensory nerve that transmits pain signals from the facet joint. The procedure is performed under fluoroscopic or CT image guidance in an outpatient setting. Because it targets the pain-carrying nerve, RFA can provide longer-lasting relief than steroid injections for appropriately selected patients.
Procedure overview
- Performed by an interventional pain physician using imaging to place a specialized probe near the medial branch nerves.
- Local anesthesia and light sedation are typically used; general anesthesia is rarely required.
- Radiofrequency energy is applied for a short period to interrupt the nerve’s ability to transmit pain signals.
- The procedure usually takes less than an hour and patients go home the same day.
Who Is a Good Candidate?
Patients who most commonly benefit include those with chronic axial low back pain attributed to the facet joints, who have had positive diagnostic medial branch blocks, and who prefer a nonsurgical approach to pain control. Candidates are evaluated for overall health, imaging findings, and prior conservative treatments. RFA is often considered when other less invasive measures, such as medications and physical therapy, have not produced sufficient relief.
Benefits and Expected Outcomes
RFA and facet denervation are intended to reduce pain, improve mobility, and allow patients to engage more effectively in rehabilitation and daily activities. Many patients experience meaningful pain reduction lasting months to over a year; nerves can regenerate over time and the procedure may be repeated if appropriate. Importantly, RFA is an outpatient, image-guided procedure that can lower reliance on long‑term opioid therapy when integrated into a comprehensive plan including medication management and rehab.
Risks and Recovery
As with any procedure, RFA carries risks that your physician will review, including temporary soreness at the treatment site, numbness, or, rarely, infection or nerve injury. Most side effects are short-lived. Typical recovery involves several days of limited activity with rapid return to light work and coordinated physical therapy to maximize functional gains.
Integrating RFA Into a Multidisciplinary Treatment Plan
At MK Spine & Joint Rehab we emphasize combining interventions with active rehabilitation. Radiofrequency ablation is most effective when paired with strengthening, flexibility and movement retraining provided by our physical and occupational therapy teams. We also coordinate medication strategies through our medication management program when needed to ensure safe, evidence-based control of symptoms. Learn more about our physical therapy services here: Physical Therapy.
For patients with broader degenerative disease or disc-related symptoms, other minimally invasive options such as percutaneous disc decompression or spinal cord stimulation may be considered. Our practice offers a full range of image-guided interventions and staged treatment pathways, described in detail in our procedural overview: Overview of Minimally Invasive Spine Procedures at Pain Clinic in Hauppauge and in our procedural guide: Radiofrequency Ablation for Neck and Back Pain in Garden City.
Why Choose a Local Long Island Practice?
MK Spine & Joint Rehab (Marvin Kalter Spine & Joint, P.C.) provides outpatient, image-guided care at our Garden City (Nassau County) and Hauppauge (Suffolk County) offices. We focus on individualized evaluation, objective diagnostic testing when appropriate (including nerve conduction studies/EMG), and coordinated plans that combine interventional procedures, medication management, and rehabilitation. Our goal is to reduce pain and restore meaningful function so patients can return to work, family life, and recreation with as little disruption as possible.
What to Expect at Your Appointment
During your consultation we will review your medical history and imaging, perform a focused examination, and discuss whether diagnostic blocks or RFA are appropriate. If a procedure is recommended, we will explain the steps, risks, likely recovery, and how the treatment fits into an overall rehab plan. You can learn more about our non-surgical spine care approach here: Comprehensive Non-Surgical Spine Treatment in Hauppauge.
Next Steps
If you suffer persistent back pain and want to explore conservative, image‑guided options such as radiofrequency ablation or facet denervation, contact MK Spine & Joint Rehab to schedule an evaluation. Book an appointment online or call to schedule a consultation at our Garden City or Hauppauge office: Contact Us. Our team will work with you to determine the safest, most effective path toward reduced pain and improved function.
References and further reading
- Mayo Clinic. Radiofrequency Ablation. https://www.mayoclinic.org/tests-procedures/radiofrequency-ablation/about/pac-20384671
- Cleveland Clinic. Radiofrequency Ablation (RFA): What to Expect. https://my.clevelandclinic.org/health/treatments/16609-radiofrequency-ablation-rfa
Frequently Asked Questions
What is the difference between a facet injection and radiofrequency ablation?
A diagnostic or therapeutic facet injection delivers local anesthetic and sometimes steroid to the facet joint or its medial branch nerve to confirm the pain source and provide temporary relief. Radiofrequency ablation (facet denervation) uses heat to interrupt the sensory nerve supplying the facet joint, often providing longer-lasting pain reduction when diagnostic blocks indicate the facet joint as the pain generator.
How long does pain relief from RFA typically last?
Pain relief varies by individual. Many patients experience meaningful relief for several months to over a year. Because the treated sensory nerves can regenerate over time, the procedure can be repeated if the clinical benefit returns.
Is RFA appropriate for all types of back pain?
No. RFA is specifically used for pain originating from the facet joints after diagnostic blocks confirm the source. It is not typically used for radicular pain caused by a pinched nerve root. A careful evaluation, imaging review, and diagnostic injections help determine appropriateness.
What should I expect during recovery after RFA?
Most patients have some local soreness for a few days and can return to light activities quickly. Your provider will give specific post-procedure instructions and recommend a rehabilitation program to maximize function and prevent recurrence.
Are there risks or side effects to RFA?
RFA is generally safe when performed by experienced providers, but risks include temporary soreness, numbness, bruising, infection (rare), and very rarely nerve injury. Your physician will discuss risks and benefits based on your health and anatomy.
How does MK Spine & Joint Rehab approach treatment planning?
We use an individualized, multidisciplinary approach that may include diagnostic nerve testing, medication management, targeted image-guided procedures like RFA, and coordinated physical or occupational therapy to restore function and reduce pain.
How can I schedule an evaluation at MK Spine & Joint Rehab?
You can book an appointment online or call to schedule a consultation at our Garden City or Hauppauge office. For contact information and directions, visit our Contact page: https://mkspinejoint.com/contact-us/.
How does MK Spine & Joint Rehab approach treatment planning?
We use an individualized, multidisciplinary approach that may include diagnostic nerve testing, medication management, targeted image-guided procedures like RFA, and coordinated physical or occupational therapy to restore function and reduce pain.
How can I schedule an evaluation at MK Spine & Joint Rehab?
You can book an appointment online or call to schedule a consultation at our Garden City or Hauppauge office. For contact information and directions, visit our Contact page: https://mkspinejoint.com/contact-us/.