Radiofrequency Ablation
For individuals living with chronic pain caused by arthritis, injury or prior surgeries, radiofrequency ablation (RFA) may provide some relief. This procedure, which uses radio waves to prevent nerves from sending pain signals to the brain, is minimally invasive and poses few risks to patients. Explore the potential benefits of RFA and what patients can expect when undergoing this treatment.
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.
Are you a good candidate for Radiofrequency Ablation?
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Positive
You have chronic pain from arthritis, injuries or prior surgeries.
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Positive
You have pain caused by damaged or irritated nerves.
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Negative
You have a tumor, metastases or an active infection.
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Negative
You take blood-thinning medications or have responded negatively to local anesthetic blocks in the past.
Frequently asked questions
How Long Does an RFA Procedure Take?
The length of the procedure varies depending on the area being treated and can range between 20 minutes and several hours. After the procedure, patients are moved to a recovery room, where they’ll spend an additional 30 to 90 minutes, depending on the level of sedation they received.
Most patients can go home the same day. However, physicians may recommend a second treatment for individuals who haven’t experienced complete relief from symptoms. RFAs typically need to be repeated after the effects of treatment have worn off, which is often within the year.
What Are the Potential Side Effects of RFA Treatment?
RFA is generally considered a safe procedure that poses a low risk of complications. However, patients sometimes experience one or more of the following side effects:
- Bleeding
- Muscle soreness
- Temporary numbness or tingling
- Itching or burning at the injection site
- Skin infections at the injection site
- Hypersensitivity of the skin at the injection site
More serious side effects, including damage to the surrounding muscles, nerves or blood vessels can occur, but these complications are rare. Patients may also experience reactions to the numbing agent or the sedative.
What Is Radiofrequency Ablation Used For?
Although radiofrequency ablation therapy is used to treat various conditions, it’s most commonly used in pain management. This technique, which is known as nerve ablation, can be used to reduce or manage chronic pain caused by the following conditions:
- Sacroiliitis
- Arthritic joints
- Spondylosis (spinal arthritis)
- Whiplash and other injuries
- Pain related to prior spine surgery
- Chronic pain of the neck, lower back, hip or pelvic area
- Neuropathic pain conditions such as complex regional pain syndrome and peripheral nerve entrapment syndrome
Because radiofrequency ablation is a minimally invasive, nonsurgical way to kill targeted tissue, the procedure is also used to shrink growths in the body, including tumors, and it’s often used in the treatment of thyroid nodules. Additionally, RFA may be used to treat chronic venous insufficiency.
What Is Recovery after Radiofrequency Ablation Like?
Immediately following the procedure, the patient is taken to a recovery room to rest before being sent home. During this period, the patient’s vital signs are monitored closely. A driver should be available to transport the patient home once they’ve been released.
Most individuals can expect to experience muscle soreness near the injection site for a few days, and ice packs may be applied to relieve pain. Patients can shower 24 hours after the procedure, and many individuals are able to resume their regular activities at that time.
Although radiofrequency ablation isn’t a permanent fix, it may provide modest relief for individuals living with chronic pain. Pain management physicians at Northeast Spine and Sports Medicine can help patients find treatment options that are relevant to their conditions and lifestyle. Schedule an appointment at one of NESSM’s many convenient locations.
Who Shouldn’t Undergo Radiofrequency Ablation?
Individuals taking blood-thinning medications or those who haven’t responded positively to local anesthetic blocks in the past may not be ideal candidates for RFA. The procedure shouldn’t be performed on anyone who has an active infection or shows signs of illness on the day of treatment. Your physician can assess your symptoms, medical history and risk profile to help you determine if this procedure is right for you.
