Pain expert Dr. Scott Fishman answers questions about back pain:

Q: I have had back pain for the past two years and have tried everything for the pain. My doctor now wants me to try a procedure called "radiofrequency lesioning." Will it help my back pain to the point that I can go back to work?

A: Back pain is very common and there are many different techniques used by pain specialists to treat it. The term "radio frequency" essentially means utilizing electricity to manage pain, typically to produce heat in the affected area. Radiofrequency lesioning utilizes radiofrequency electricity to produce heat in order to melt away nerves or other tissues.

Radiofrequency is used to treat several areas of the back causing back pain, such as diseased or injured facet joints or the spinal discs. The facet joints prevent us from being able to lean and bend as far backward as we are able to bend forward. These joints can become diseased and cause significant amounts of pain in the back. The radiofrequency lesioning procedure can be used to melt away nerves that cause pain within these facet joints of the back.

When utilized to treat back pain in the spinal discs, there is a special type of radiofrequency utilized called IDET, or Intradiscal-Electro-Thermal-Annuloplasty, which is a big term for threading a thin filament into the disc and applying heat to the inside surface. The heat serves to do many different things, one of which is to reduce pain. However, physicians are not absolutely sure what exactly the mechanism is for reducing this pain; we believe it may have to do with melting the pain nerves within the disc, or by helping the disc to restructure itself and become more supportive and sealed.

Radiofrequency is usually a technique that is used to directly damage tissue in hopes of actually healing the tissue and relieving pain in the body. This procedure is almost always accompanied by some degree of risk. Thus, the use of this technology must be accompanied with caution and care, particularly with consideration for the long-term risks of the therapy.