Radiofrequency Ablation
Radiofrequency ablation is a procedure that uses a specialized machine and needles to semi-permanently interrupt nerve transmission of pain signals. The nerves are typically blocked for a period of 3 months to 12 months. Individual responses vary widely.
Am I a candidate for Radiofrequency Ablation (RFA)?
Your Pain Doctor along with your referring physician will determine if you are an appropriate for an RFA. Typically, it is required that you have responded favorably to more temporary diagnostic blocks to be a candidate for an RF ablation procedure. Usual conditions treated by RFA include Cervical Headaches, Neck Pain, Back Pain, Whiplash, Facet Joint Disease, and certain Neuropathies.
What are the benefits of an RFA?
The technique works to disrupt nerve conduction of pain signals thereby potentially reducing the experience of pain. Approximately 80% of patients will get a good response of the targeted nerves. This should help relieve pain from the cervical, thoracic and lumbar spine. On occasion, after certain areas are blocked, it becomes clear that other areas of the body are generating pain as well.
How long does the procedure take?
The entire procedure will take approximately 45 minutes.
Where is the procedure performed?
It is typically done in an office or surgical suite using fluoroscopy.
How is the procedure performed?
Your doctor will typically identify the area he will be treating using a fluoroscope (x-ray machine) and then use local anesthetic numbing medication (Lidocaine) before placement of the treatment needle. The needles are advanced using fluoroscopy to identify bony landmarks where the nerves are typically located. Needle position is confirmed with electrical stimulation, and the x-ray images. You are awake during the procedure and may experience muscle twitching, buzzing, tingling, or a burning sensation during electrical testing. Once needle placement is confirmed, the needle tips are heated to 80 degrees Celsius for 105 seconds, as current passes from the radiofrequency machine to the tip of the needle, where heat is generated.
Is it painful?
Generally, no, your doctor will do everything possible to minimize any discomfort during the procedure. This may require sedation but is typically achieved with the anesthetic numbing medication alone (Lidocaine).
What about after the procedure, will there be pain?
Sometimes there is post-procedural pain. This can be the result of nerve irritation or soft tissue trauma that occurs following the insertion of the needles. This may result in muscle soreness for up to one week following the procedure. Ice and or heat will typically help to control the pain. Anti-inflammatory medications can also be helpful.
What are the risks and side effects?
The procedure is generally safe. However, with any procedure or medications there are potential risks, complications, and side effects. The potential risks to a certain degree depend on the region of the treatment. Whenever a needle is introduced through the skin there is risk of infection, bleeding, and soreness. For this reason, all our procedures are performed under sterile technique, and a careful history is taken to ensure any risks of bleeding are minimized. On occasion, one may develop numbness due to spread of the local anesthetic. The nerves being lesioned are near blood vessels and other nerves, which can be potentially damaged. Great care is taken when placing the radiofrequency needles to minimize complications.
Can I return to work the next day?
Generally, yes, unless you experience prolonged pain or soreness at the injection and treatment sites.
How long does the RFA last?
Responses vary depending on the underlying condition, severity of illness, and coexisting diseases. Some people have an immediate response to the procedure. Other’s pain may be gone or significantly reduced within a matter of weeks of the procedure. Some patient’s have a partial response and may require additional treatment to achieve a more robust improvement in pain control. If successful, the procedure may last for several months to years. The procedure can be repeated when the nerves regenerate if necessary. You will be re-evaluated following your procedure by your doctor at 4 to 6 weeks.
