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 several years. Individual responses vary.
Am I a candidate for Radiofrequency Ablation (RFA)?
Your Pain Doctor along with your referring physician will determine if you are appropriate for an RFA. Typically it is required that you have responded favorably to more temporary diagnostic blocks to be a candidate for an RFA ablation. 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 reducing the experience of pain. Approximately 80% of patients will get a good block of the targeted nerves. This should help relieve pain from that particular area. 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 20 -30 minutes.
Where is the procedure performed?
It is typically done in an office or surgical suite using fluoroscopy.
How is the procedure performed?
Typically an IV is started so that the anesthesiologist can administer sedating medication to make you comfortable. Your doctor will typically identify the area he will be treated using the X-ray machine, and then provide some local numbing medication (Lidocaine) before placement of the needle. The needles are advanced using x-ray guidance to identify bony landmarks with the nerves typically are. Needle position is confirmed with electrical stimulation, and the X-ray images. If you are awake during the procedure you may experience muscle twitching, buzzing, tingling, or a burning sensation. Sometimes it can be helpful to be awake for part of the procedure so you can indicate what you are feeling to your doctor. Once needle placement is assured, the needle tips are heated to 80 degrees for 90 seconds, as current passes from the Radiofrequency Machine to the tip of the needle. Typically 3 lesions are made at each site.
What if I am afraid of needles?
Typically patients with needle phobia do just fine with sedation to help relax them. They also typically will have little to no memory of the actual procedure.
Is it painful?
Generally no, your doctor will do everything possible to minimize and discomfort during the procedure. This may require sedation and is typically achieved with the numbing medication (lidocaine).
What about after the procedure, will there be pain?
Sometimes there is post-procedure 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 afterwards. 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 risk, complications, and side effects. The potential risks to a certain degree depend on the region of the epidural. 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 do to extensive spread of the local anesthetic. The nerves being lesioned are near blood vessels and other nerves, which can be potentially damaged. Rest assured, great care is taken when placing the radiofrequency needles so as to minimize complications. That being said sometimes complications do occur. Please discuss any specific concerns with your doctor.
Can I return to work the next day?
Generally yes, however sometimes soreness at the injection area causes you to be off work for a day or two.
How long does the RFA last?
A person’s response will vary depending on their underlying condition, severity of illness, and lifestyle. Some people have an immediate response to the procedure. For others pain may be gone or significantly reduced within a matter of weeks. Others have a partial response and may require additional injections to achieve more robust improvement. Some fail to respond completely. If successful the procedure may last for several months to years. The procedure can be repeated if and when the nerves regenerate if necessary and desired. You will be re-evaluated following your procedure by your doctor.