Radiofrequency ablation, commonly referred to as RFA, is an effective long-term treatment for mechanical neck and low back pain due to joint inflammation. The goal of radiofrequency ablation is to provide long term relief of joint mediated pain than regular steroid injections can provide. The treatment is indicated once the joints have been precisely identified as a primary pain generator and steroid injections are only effective for short periods of time. In the spine, radiofrequency ablation is used for facet joint and sacroiliac joint pain.
RFA is a treatment option for patients with chronic neck or back pain who have experienced significant pain relief after a diagnostic nerve block.
RFA is performed under fluoroscopic, or x-ray guidance. As the patient, you will be asked to lay on your stomach on the x-ray table. You may receive medication through your IV to make sure you are comfortable during the procedure. Pictures will be taken to identify the area being treated. After the skin is cleaned and sterilized, numbing medicine is injected in the skin. The RFA needle is then inserted and placed next to the nerve we are treating using the x-ray to guide the needle. Once we are in position, the nerve is tested to confirm we are in the correct position. The nerve is then numbed with more local anesthetic and the radiofrequency current is turned on. This generates heat to create a small, precise burn over the portion of the nerve that transmits pain. The burn takes 90 seconds, and multiple nerves can be burned at the same time. Once the ablation is completed, the needles are removed and band-aids are placed.
Most patients will experience pain relief lasting at least 6 months to one year after RFA. Some patients are pain-free for much longer. Eventually, the nerves will regenerate and the pain can return. That’s ok because this procedure can be repeated to achieve pain relief again. This is an ideal procedure to minimize the amount of steroid injections a patient may need to get symptom relief.
We recommend someone drive you home after the procedure. For the first day or two, we recommend a period of relative rest before getting back to work or normal activities. Avoid submerging in water for two days after the procedure to reduce infections risk (no baths or swimming). Showering is OK.
As your pain improves, you can resume exercise or other activity, but it is important not to over do things. We may recommend a physical therapy program to rebuild muscle and core strength and to develop a long-term exercise program not just for your pain, but for your overall health!
Reviewed by: Dr. Christopher Good.