Radiofrequency ablation (RFA) is a nonsurgical procedure that may be used to treat severe chronic neck and back pain, arthritis and pain caused by a variety of other conditions. This nonsurgical procedure, which usually takes place in a physician’s office or hospital on an outpatient basis, uses radio waves to heat up a small section of nerve tissue, disrupting pain signals to the brain. Treatment may provide long-lasting relief for some individuals.
How Does Radiofrequency Ablation Work?
Radiofrequency ablation provides pain relief from irritated or damaged nerves. The treatment uses a radiofrequency current to heat up small amounts of tissue in the affected area, creating a heat lesion on the nerves and preventing them from carrying a pain signal to the brain.
Prior to treatment, most patients are positioned on a procedure table; although, treatment of certain areas of the body may require the patient to be in a sitting position. The doctor or anesthesiologist then gives the patient intravenous medication to relax them and a local anesthetic to numb the target area. Although mild sedation may be used, the patient must be kept awake and alert throughout the procedure to relay what they feel during the radiofrequency stimulation.
To perform the RFA, the doctor inserts a thin needle into the area where the pain originates, sometimes using an X-ray or ultrasound to help pinpoint the treatment area. The doctor then inserts a microelectrode through the needle, which is used to deliver a small radiofrequency current to the affected nerve. These radio waves heat the targeted nerve tissue, disabling it and interrupting the pain signal. In some individuals, the stimulation may temporarily recreate the pain they typically experience. The process may be repeated on multiple nerves. Patients can usually go home the same day.
Types of Radiofrequency Ablation
The following types of radiofrequency ablation are commonly used in pain management:
- Conventional or thermal: Conventional RFA uses heat to create a lesion, destroying nerve tissue so it can’t send pain signals to the central nervous system.
- Pulsed: Pulsed ablation uses a higher voltage than conventional RFA, generating less heat so it may be used without risking a loss of sensation or movement in the treated area.
- Cooled: Cooled RFA sends RF currents to the relevant nerves via a cooled electrode. It’s often used to treat sacroiliac joint pain.
- Water-cooled: Water-cooled ablation treatments create a larger lesion by using multichannel electrodes and a continuous flow of water to temperatures lower than those reached during conventional RF ablation.