Radiofrequency ablation is a treatment option for chronic pain that is gaining popularity for both its effectiveness and minimal side effects. First used in 1931 to treat a patient with trigeminal neuralgia, radiofrequency ablation has become the standard of care for several chronic pain conditions. In this post, we answer some of the most frequently-asked questions about this procedure, starting with: what is radiofrequency ablation?
1. What is radiofrequency ablation?
Radiofrequency ablation is a non-surgical, minimally-invasive pain treatment. An electrical pulse produced by radiofrequency waves directs heat to a precise area of your nerve tissue. Once that nerve is damaged, it disrupts the pain signals that were being transferred to the brain from that area.
Radiofrequency waves, according to Spine Dallas, are:
“Electromagnetic waves which travel at the speed of light, or 186,000 miles per second (300,000 km/s). Radiofrequency energy is a type of heat energy that is created by a special generator at very high or super high frequencies.”
Once the nerve tissue is destroyed with these waves, radiofrequency ablation can reduce or stop your pain entirely. Pain doctors most often perform this procedure for patients with lower back pain or neck pain. These pain specialists first perform a medial branch block to successfully identify the nerve tissue that is causing your pain. Then, they’ll use radiofrequency ablation to burn, or “ablate,” the correct nerves.
Using these two procedures together increases the potential for effective pain relief.
2. What are its benefits?
After a radiofrequency ablation procedure, you can experience pain relief for nine months, up to two years. As Mayfield Clinic reports, this procedure is 70-80% effective in patients who have already had successful nerve blocks.
Benefits also include:
- Avoid invasive surgeries or medications
- Improved mobility, function, and quality of life
- Typically immediate pain relief
- Little to no recovery time
3. What is radiofrequency ablation procedure like?
Radiofrequency ablation is often performed as part of a comprehensive pain management plan after other pain-relieving options have been tried. This procedure is often recommended before more invasive surgery since it’s minimally-invasive and provides long-lasting pain relief.
You may choose to have local anesthetic or mild sedation during the outpatient procedure. You’ll be lying or sitting comfortably, depending on the source of your pain. Once the area is numb and you are comfortable, the doctor will use fluoroscopy to guide a needle into the area for the radiofrequency ablation procedure. Your doctor will then move a small microelectrode through the needle and place it near the targeted nerve tissue.
At this point, a very mild electrical current is sent through the microelectrode to check for proper placement. Once the microelectrode is properly placed, your pain specialist applies a numbing agent before delivering the heat-generating electrical current to your targeted nerves. If inflammation is present, corticosteroids may also be administered.
This electrical current may be conventional, or sent as pulses at a higher voltage level. Ainsworth Institute talks about the different types of radiofrequency ablation in more detail. Your pain doctor will work closely with you to find the best option for you.
The whole procedure from start to finish should only take 30 to 90 minutes, depending on the number of nerves targeted. The procedure itself should be completely pain-free. If you experience pain during radiofrequency ablation, you should immediately inform your doctor, as this could mean you require more numbing agent. It may also mean that the proper nerve tissue has not been targeted.
4. Where can I watch a video of radiofrequency ablation?
Sometimes it’s easiest to visualize the procedure by watching a video of radiofrequency ablation performed. Dr. Paul Lynch from Arizona Pain Specialists performs radiofrequency ablation for lower back pain in the following video. In the video, he gives a clear description of what’s going on and what you can expect.
5. What is lumbar radiofrequency ablation?
The most common condition treated with radiofrequency ablation is pain in the lumbar facet joint or lower back. Therefore, “lumbar radiofrequency ablation” is simply radiofrequency ablation that treats pain in the lower back.
In order to understand how radiofrequency ablation for back pain works, it is first helpful to understand the anatomy of the spine. The spine consists of 24 vertebrae stacked one upon the other. Between these vertebrae there are intervertebral discs. These are gel-filled sacs that cushion and protect each vertebrae as they move. Facet joints connect the vertebrae together. These provide stability in the spine but also support movement.
The spinal cord runs up the length of the spine, sending all types of signals to the brain (including pain).
When any part of this system is disrupted, debilitating back pain can result. A herniated or bulging disc may cause the vertebrae to rub together, causing inflammation or compressing nerves in the spinal cord. Injury to the facet joint may cause pain. Other injuries or diseases can also lead to back pain.
As discussed in the procedure overview, radiofrequency ablation damages nerves that transmit pain signals to the brain. If you’re one of the millions of people in the U.S. who suffer from back pain, radiofrequency ablation for back pain could provide a viable and minimally-invasive option for treating your pain.
After a systematic review of randomized controlled trials (RCTs), researchers in Pain Research Management reported that:
“The evidence supports RFA as an efficacious treatment for lumbar facet joint and sacroiliac joint pain, with five of six and both of the RCTs demonstrating statistically significant pain reductions, respectively.”
6. Can I see a radiofrequency ablation for back pain video?
The following video gives a deeper, clinical radiofrequency ablation for lower back pain procedure.
7. What is cervical radiofrequency ablation?
Just like lumber radiofrequency ablation, cervical radiofrequency ablation refers to where the radiofrequency waves are directed. Cervical simply points to radiofrequency ablation for neck pain, or treatment in the upper cervical spine. Neck pain is one of the most common chronic pain conditions, with millions of sufferers worldwide. Cervical radiofrequency ablation offers these patients an opportunity to find minimally-invasive, non-surgical relief for their pain.
You can watch a video of radiofrequency ablation for neck pain below.
8. What are other uses for radiofrequency ablation?
Since radiofrequency ablation for lower back pain and neck pain are so common, it makes sense that this procedure is also suggested for arthritis patients who suffer from pain in these areas. Radiofrequency ablation for arthritis can help reduce the pain and inflammation associated with joint degeneration. However, there are other uses, including:
- Radiofrequency ablation for knee pain
- Radiofrequency ablation for whiplash
- Ablation for complex regional pain syndrome (CRPS)
- Radiofrequency ablation for headaches
- Radiofrequency ablation for migraines
This procedure doesn’t just manage pain. It can also treat:
If you suffer from any of these conditions, talk to your doctor today to see if radiofrequency ablation could help you.
9. What to expect after radiofrequency ablation procedure?
The entire procedure, from walking in the door to walking back out to the car, takes only a few hours. You’ll rest briefly after radiofrequency ablation and then you should have someone drive you home. It can take a month or so for patients to feel the full effects of the treatment, but in many cases pain relief can last for a year or more.
For the first two days after your radiofrequency ablation procedure, you’re cautioned to avoid the following:
- Driving or operating heavy machinery
- Vigorous exercise or activity
- Entering water (i.e., bathing or swimming)
You can also gradually return to your previous levels of activity as you feel able. Keep bandages at the injection site clean and change frequently to avoid infection.
10. Can radiofrequency ablation be repeated?
Yes, radiofrequency ablation can be repeated.
In some cases, radiofrequency ablation does not work adequately the first time. The procedure may be repeated two to three weeks after the first attempt. In addition, nerves that have been damaged may regenerate within a year and half. This may result in some pain, but often not at the level previously experienced. Talk to your doctor if you believe you would benefit from a repeated radiofrequency ablation procedure.
11. How often can you have radiofrequency ablation?
“What is radiofrequency ablation?” is the most common question we hear about this procedure. Closely following that is how often patients can have the procedure.
How often you can receive radiofrequency ablation will depend on your specific symptoms and any risk factors you have. For many patients, radiofrequency ablation benefits last for a year or more, after which time they can receive another procedure. If radiofrequency ablation hasn’t helped your pain at all, even after a second attempt, you should talk to your doctor about other pain management options.
12. Are there radiofrequency ablation side effects?
Although radiofrequency ablation is considered a minimally-invasive procedure, as with any procedure there is the chance of side effects. These may include:
- Infection, bruising, or bleeding at the injection site
- Mild back pain (unrelated to treated pain)
- Leg numbness
- Temporary increase in pain
- Allergic reaction to numbing agent or steroid injection (if used)
The above side effects should diminish within 72 hours and are usually mild. Patients can alternate hot and cold packs on the back to relieve temporary pain and swelling at the site of the procedure.
In some cases, side effects can be severe. These may include motor deficits, paralysis, muscle weakness, and severe pain. A fever over 100.4°F requires immediate medical attention, as does fluid draining from the injection site, as these can indicate a potentially serious infection. Contact your doctor immediately if you have any of these symptoms.
13. Is radiofrequency ablation painful?
Radiofrequency ablation itself should not be painful. Your pain doctor should work closely with you before and during the procedure to make sure that you have appropriate amounts of anesthetic to reduce pain. Talk to your doctor about your concerns, and make sure they’ll work to manage your pain during the procedure itself.
Many patients also worry about pain after radiofrequency ablation. During the procedure, there is damage to your nerves and in some cases the tissue around it. And while this damage is largely restorative, there may be a few days of soreness or pain after your procedure. When your anesthetic wears off, you may experience mild pain near the injection sit. This should only last for a few days. You can treat this pain with over-the-counter medications or other aftercare specified by your doctor.
You may also have general soreness for up to two weeks after the procedure, depending on the type of radiofrequency ablation performed. This pain should be less severe than pain you experienced before the procedure. If your pain continues unabated, talk to your doctor.
14. What if radiofrequency ablation doesn’t work?
Even though radiofrequency ablation provides pain relief for most, it does work better in some patients than others. If you’re working with a highly-qualified pain specialist, they’ll have first performed a medial branch block to target the source of your pain. This can ensure that you’ll have better outcomes from radiofrequency ablation.
Others, however, won’t find the pain relief they were hoping for. In this case, your pain doctor will work with you to find other treatment options. These may include epidural steroid injections or spinal cord stimulation, depending on the cause of your pain. Comprehensive pain management doesn’t rely on one fix, because pain doctors know that every patient’s body and source of pain is different. They’re committed to finding the right treatment to relieve your pain.
15. Can I get radiofrequency ablation?
By now, you should be able to answer the question, “What is radiofrequency ablation?” But that doesn’t mean you know for sure if it would work for you.
When working with a pain specialist, they’ll first discuss common risk factors that increase the risk of side effects for this procedure. Radiofrequency ablation risk factors include:
- Weight over 250 pounds
- Active infection (e.g., sinus infection or a cold)
- Poorly controlled diabetes
- Blood clotting issues
- Steroid users
If you suffer from any of these, it may mean that radiofrequency ablation isn’t the right procedure for you. However, if you’ve avoided these risk factors and have tried other pain treatments with no success, radiofrequency ablation might be a great option for you! Overall, radiofrequency ablation is a low-risk, well-tolerated procedure for many patients that offers long-term pain relief. Click the button below to find a pain specialist in your area who performs radiofrequency ablation.