Radiofrequency ablation (RFA) is a minimally invasive medical procedure that uses high-frequency electrical current to cauterize or “ablate” nerves in the body. Radio waves are sent through a precisely placed needle to heat an area of the nerve. The current destroys that area of the nerve, preventing it from sending pain signals to your brain. If there is no signal for the brain to feel, then you will experience less pain.
Goals of Radiofrequency Ablation
- Reduce neck, back, or major joint pain for longer periods of time, typically for more than 6 months.
- Improve neck, back and joint function for more range of motion, which may allow the patient to continue with a physical therapy program.
- Reduce the intake of pain medications, which can have serious side effects or risks when used long term.
- Avoid or delay surgery, which could carry additional risks and a long recovery period.
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Conditions Treated By Radiofrequency Ablation
RFA is considered for the treatment of long-term pain conditions, especially of the neck, back or arthritic joints that haven’t been successfully treated with other methods. One of the most common uses of radiofrequency ablation is to treat spine pain that is caused by arthritis of the facet joints (spondylosis) in lower back, mid-back, or neck.
Other conditions that can be treated with RFA:
- Cervicogenic headache
- Occipital neuralgia
- Sacroiliac joint or posterior pelvic pain
- Stomach pain caused by pancreatic cancer
- Pelvic pain caused by ovarian cancer
- Osteoarthritis of the knee or shoulder
Before the Procedure
The doctor performing the procedure will review your medical history and previous imaging studies to decide the most appropriate location for the ablation. Your provider will first perform a test, called a diagnostic block, to confirm the region and typical level of your pain, which can then predict the potential level of your pain relief. The block consists of an injection of a local anesthetic near the area of pain. If the diagnostic block does not provide significant relief, you may not be the best candidate for RFA. If you do have a favorable response to the diagnostic block, your provider may suggest RFA as a treatment to ease your pain. Sometimes more than one diagnostic block is necessary, particularly in the spine.
During the procedure
If you are considered a good candidate for RFA, you will be scheduled for the procedure. You will need to make arrangements to have someone drive you to and from the procedure on the day of the ablation. During the procedure, your doctor will begin by using a local anesthetic to numb the area of your skin where the needle will be inserted. Then, a small hollow needle is inserted into the targeted nerve that is causing pain. Needle placement is guided by a type of real-time, continuous X-ray called fluoroscopy. A local anesthetic is injected through the needle to numb the target area. An electrode is then inserted into the top of the needle, which sends the radio waves through the needle to the targeted nerve. The heat causes a lesion that prevents the nerve from sending pain signals to your brain.
After the Procedure
Following your radiofrequency ablation procedure:
- You’ll go home shortly after your procedure. Someone must drive you home.
- Rest when you get home. Don’t drive or do anything strenuous for 24 hours after the procedure. After a day or two, you can return to your normal activities, including bathing or showering.
- It is common to be sore for a couple of days after the procedure. Ice, anti-inflammatories, and rest can help with this.
The pain relief after the procedure may be immediate, but it may take up to 4 weeks to see the full effect.
How Long Does RFA Last?
Most people have some pain relief after radiofrequency ablation, but the amount varies by cause of pain and location. Pain relief can be immediate in some people, occur within 10 days in other people or may take up to 4 weeks in others. Pain relief typically lasts around 1 year, but may be shorter. For some people, the relief lasts a few years. Eventually, the nerve returns to normal and then the pain comes back. When this happens, the RFA can be repeated, typically without the need to repeat the diagnostic blocks..
RFA is considered for long-time pain conditions involving your spine after other methods, such as pain medication and physical therapy have not been successful. RFA is helpful for many people who decide to have the procedure. Talk with your provider to see if radiofrequency ablation is right for you.
For more information on Interventional Pain Management in San Antonio, give us a call today at (210) 963-7493. If you would like to request an appointment online, you can do so through our convenient online appointment request form.