What is Radio Frequency Ablation?

For people who are suffering from pain caused by a problematic nerve, radio frequency ablation or RFA may be a solution. This minimally invasive procedure can provide immediate relief from many pain conditions like neck or back pain by destroying a nerve. If you respond positively to a diagnostic nerve block, then you are probably a good candidate for radio frequency ablation.

Who Should Consider Radio Frequency Ablation?

It may sound exciting to hear that there is a procedure that can neutralize a nerve or nerve cluster, silencing the pain that they produce, but you should know that radio frequency ablation is not for everyone with a pain condition.

Radio frequency ablation is most used to treat the following pain conditions:

  • Spondylosis or arthritis of the spine—as you age, your spinal discs may thin and move, allowing the spinal vertebrae to rub against one and produce bone spurs. Slipped discs or bony formations can press against spinal nerves causing pain, tingling, numbness, or weakness.
  • Sacroiliitis—the sacroiliac joint is where the spine meets the pelvis. If there is inflammation in one or both joints, possibly due to arthritis or trauma, then pressure may be applied to nerves passing through the joints and produce pain.
  • Joint degradation—patients with joint degeneration due to arthritis may be good candidates for RFA. Although RFA may not treat the actual damage to the joint, it may be able to neutralize pain symptoms by incapacitating a nerve cluster.
  • Trigeminal neuralgia—pain symptoms associated with the trigeminal nerve in the face may be managed with radio frequency ablation. RFA will target the base of the trigeminal nerve, producing numbness throughout the face.

You may want to discuss the possibility of radio frequency ablation treatment with your doctor if you exhibit the following:

  • Experienced pain relief from a nerve block—if your doctor successfully performed a nerve block injection and you experienced a reduction in pain symptoms, then the problematic nerves have probably been well identified.
  • Drug resistance—if your pain medications are no longer effective, then RFA might be a safer alternative.
  • Pain in certain patterns—if your pain appears when you assume only certain positions then it is likely due to pressure on specific nerves. Also pain that only radiates through your arms or legs may signify nerve impingement.

If you have the following conditions, you should not receive RFA treatment:

  • You have a bleeding condition or on medications that make you prone to bleeding.
  • You have an active infection.

The Radio Frequency Ablation Procedure

A radio frequency ablation procedure is normally performed in a doctor’s office on an outpatient basis. Prior to the procedure, you should not eat anything within six hours prior to the procedure and drink only clear liquids up to two hours prior to the procedure. You should also stop taking any blood clotting medications two weeks before the procedure.

In preparation for the procedure, your doctor will administer a local anesthetic to numb the area. You may feel some minor discomfort during the procedure, but in most cases, there is no need to put you completely under. If necessary, your doctor may give you a mild sedative.

Using a fluoroscope (x-ray) to guide the inserted hollow needle, the physician should direct the needle to the nerve. In some circumstances it may be necessary to inject a contrast dye that should make locating the target nerve easier.

Once the needle is properly positioned, then a radio frequency current is passed through the needle for about 90 seconds. That should cauterize the nerve, eliminating the ability to send pain signals. If necessary, the doctor may reposition the needle to ablate other nearby nerves. Every radio frequency ablation treatment takes about 20 to 60 minutes.

After the Procedure

Once the radio frequency ablation procedure is completed, you will be monitored for a short period in case there are any adverse reactions. You will probably be able to walk out of the clinic on your own, but you should arrange for someone to drive you home.

At home, you should apply an ice pack to the injection site to relieve an inflammation and discomfort. Keep the ice pack on for a maximum of 20 minutes; repeat icing applications three or four times during the first day. Do not take a bath within 48 hours of the procedure; you may take showers. Do not engage in any strenuous activities the 24 hours following the procedure.

In the two weeks immediately after the RFA, you may experience some pain, but this is usually related to the nerve ablation or muscle spasms. In about 70 percent of cases, radio frequency ablation will provide some pain relief. In most cases, pain relief should appear within ten days of the procedure, but it has been known to take up to three weeks.

If you have been incapacitated by your pain condition, you may feel over-enthused about being pain-free. This presents the potential for re-injuring yourself which is why your doctor may recommend that you work with a physical therapist. A physical therapist can alert you to actions that could injure you and teach you safe alternatives, as well as help strengthen and stretch key muscles.

This pain relief may last from nine months up to more than two years. It is possible for the nerve to regrow after ablation; if it does regrow, it usually takes about six to twelve months. If necessary, your doctor can repeat the procedure.

Potential Risks

Radio frequency ablation is a very safe procedure, but there are some possible complications as there are with any procedure. These include

  • Nerve pain
  • Neuritis (nerve inflammation)
  • Neuroma (pinched nerve)
  • Numbness
  • Infection
  • Allergic reaction to used medications

Your doctor should explain the risks involved and what you should do if they arise. In any follow-up visits, you should be frank and open about any pain or discomfort you are experiencing so that your medical team can help resolve them with alacrity.

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care

M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees.  The information contained in this article does not constitute medical advice, nor does reading or accessing this information create a patient-provider relationship.  Comments that you post will be shared with all visitors to this page. The comment feature is not governed by HIPAA and you should not post any of your private health information.