Radiofrequency Nerve Ablation

Radiofrequency Nerve Ablation

Radiofrequency nerve ablation (RFA) is a treatment that uses a special type of needle to apply radio waves or an electric current to a painful nerve, which in turn “stuns” or “burns” the nerve, essentially eliminating the transmission of pain signals to the brain. This exciting procedure offered by Advanced Pain Consultants can provide long-term pain relief to people with chronic pain, especially in the lower back, hip, neck and arthritic joints.

One of the most common uses of radio frequency nerve ablation is to address pain emanating from the facet joints. These are the joints located in the spine, which link the vertebrae together. Facet joints facilitate flexibility and enable a wide range of movement, such as bending, walking and twisting. When the thin layer of cartilage covering the facet joints breaks down, this can cause inflammation and pain (especially during movement), which range from slight to severe. The general term for this condition is osteoarthritis in the spine, or spinal arthritis.

Who is a candidate?

The majority of our patients who receive RFA have spinal arthritis, either in the lower back (lumbar spine), upper and middle back (thoracic spine), or neck (cervical spine). Spinal arthritis is relatively common and is most often seen in people over age 60. Many of our patients who request RFA for osteoarthritis treatment are in indeed in this age group.

Other conditions that can be effectively treated with radio frequency ablation include:

  • Post-traumatic pain (whiplash).
  • Prior spine surgeries.
  • Post-laminectomy syndrome (persistent pain after spine surgery).
  • Herniated intervertebral discs.
  • Neuropathic pain conditions (e.g., complex regional pain syndrome or peripheral nerve entrapment syndrome).

Oftentimes patients who undergo RFA have previously tried other pain-relieving treatments, such as epidural steroid injections, nerve blocks, anti-inflammatory medication or physical therapy, but did not get the level of relief they had desired. They are hoping RFA can help them, and in most cases it does. In general, RFA provides considerably longer pain relief that what standard pain injections or nerve blocks can do.

As is true with most medical treatments, RFA is not appropriate for everyone. RFA is not recommended for people who have an active infection, uncontrolled diabetes, heart disease or bleeding problems. People with these conditions should not undergo the procedure, or at least postpone having RFA until after their medical condition improves.

How RFA is performed

Radio frequency ablation is done on an outpatient basis, and generally lasts 30 to 90 minutes, depending on the number of areas that are being treated. Before the procedure, patients will be given local anesthesia, along with light intravenous sedation, if needed, to reduce discomfort.

Once the anesthesia has taken effect, Dr. Pasi will insert a thin needle near the facet joint. Fluoroscopy, a type of x-ray, will then be used to position the needle. Dr. Pasi will check to make sure it is located at the correct nerve by stimulating it. This may cause muscle twitching or provoke some pain. Once the needle

is in the right position, the radiofrequency probe is inserted through the needle. The tip of the probe is heated and the nerve is destroyed. When finished, the needles are removed and a bandage is applied.

Patients can normally go home following a short recovery period. Dr. Pasi recommends patients take it easy for the first 24-hours after they get home. Work and other normal activities can be resumed the following day. Recovery is generally quick, although patients may have a sore back or neck for one to two days after the procedure. 

Results

The positive effects of RFA can be felt in as soon as 2 to 3 days after the treatment. Depending on the cause and location of the pain, the degree of relief does vary from patient to patient. It is also important to understand that RFA is not effective in everyone, although it is effective in the majority (70 percent) of patients.

Of the patients who report successful results, pain relief generally lasts from 8 to 12 months. For some people, relief can last for years. Relief is not permanent, though, as stunted nerves will start to grow again after the RFA procedure. However, patients who undergo physical therapy after their RFA treatment (while the nerves are still stunted) may find they have less joint pain when the nerves do regenerate and may not even need a repeat RFA treatment. But if patients do have a recurrence of pain, the good news is this procedure can be repeated.

What’s the bottom-line? If you are suffering from chronic back pain or arthritis, the most important step you can take is to seek medical attention. If you live in the Raleigh area, call Advanced Pain Consultants at (919) 510-790 to schedule a consultation with Dr. Pasi to learn more about radiofrequency nerve ablation and discuss your treatment options. The sooner you seek treatment, the sooner you can start feeling like your old self again.