Radiofrequency ablation (RFA) is an outpatient procedure in which a specialized needle is used to apply heat directly to the nerves that are causing pain. After a nerve is heated in this way, it is unable to continue sending pain signals. Radiofrequency ablation is most commonly used to treat pain arising from the joints between the vertebrae in the spine, called facet joints.
Prior to recommending an RFA, your doctor will order a series of medial branch block procedures and review how your pain changed in response to them. Medial branch block is a diagnostic procedure that helps determine if you are likely to get relief from an RFA. If you get temporary relief from a series of medial branch blocks, then you have a greater chance of getting good pain relief from an RFA.
Radiofrequency energy has been used in medical procedures for over 75 years and is very safe. The RFA procedure itself has no risk of paralysis or weakness and very low risk for infection and neuralgia. Most patients have minimal difficulties with the procedure.
Commonly used to treat or diagnose pain due to:
- Back pain from arthritic facet joints
When you come in for the procedure, you will have the opportunity to speak with a clinical staff member in order to have any questions answered, and you will sign a consent form. In the procedure room, you will lie on the treatment table, and the area on your body to undergo the treatment will be sterilized. A radiology tech will be present to guide the fluoroscope (x-ray machine) that your doctor will be using to visualize the needle. You will be given a local anesthetic to decrease the pain of the procedure. The needle will be placed against the nerve that is causing you pain, and will produce heat to disable the nerve’s ability to transmit pain. It takes about a minute and a half for the heat to work on the nerve, and each nerve must be treated at more than one site to increase the chances of pain relief.
Some patients may find this procedure to be painful. If you do feel pain, you should tell your doctor, as he may be able to make adjustments to reduce your discomfort. An entire RFA procedure usually takes about 30 to 45 minutes. When it is finished, the needle is removed and the site is covered by a sterile bandage. Following the procedure, you will be able to rest in a recovery area. You will be provided with discharge instructions. You will need to have a responsible adult with you to drive you home.
Recovery and Benefits
Recovery after the procedure
You may call Louisiana Pain Specialists if you have any concerns during your recovery from the procedure. After an RFA, you may feel a slight increase in pain for one to two weeks. You may use pain medicines, ice, and rest to reduce your pain.
Within four weeks, your pain is likely to be greatly reduced. It is possible that the nerves causing the pain may return over six to twenty four months after the procedure. Attending physical therapy and staying active can help build muscle strength and reduce your pain in the case that the nerves begin to deliver signals again. If they do return, they are likely to cause you less pain than before, and the procedure can be repeated to achieve similar results.
Studies have shown that RFA can reduce pain severity and frequency in the majority of patients for one to two years.
“Before my procedure, I was in bad condition. I had trouble walking because my back was hurting so bad. I’ve always cleaned my house myself because I like everything just so, but I had to hire someone to do it because of my pain. After my procedure, I got immediate relief. I was able to increase my activity level. I was able to get back to cleaning my own house and gardening. I have my life back.”
–Eva G., 75, Patient who received RFA procedure