What is radiofrequency ablation?
Radiofrequency ablation (also known as radiofrequency neurotomy) is a common treatment method for neck and back pain caused by injury/trauma, arthritis, and other degenerative conditions. Unlike other treatment options, radiofrequency ablation does not rely on drugs or steroids in providing pain relief. Instead, the technique involves the direct application of intense heat, which “burns” pain-inducing nerves.
Technically speaking, radiofrequency ablation is applied to either the medial branch nerves (which transmit sensation from the facet joints) or lateral branch nerves (which transmit sensation from the sacroiliac joints).
What does radiofrequency ablation treat?
Radiofrequency neurotomy can treat:
- Neck pain. (Cervical Facet Radiofrequency Neurotomy)
- Upper back pain. (Thoracic Facet Radiofrequency Neurotomy)
- Lower back pain. (Lumbar Radiofrequency Neurotomy)
How is radiofrequency ablation performed?
Before undergoing radiofrequency ablation, your pain management specialist will already have performed a lateral or medial branch block (depending on your pain) to pinpoint the nerves that are transmitting your pain. Also, it’s likely that your pain management physician will have already attempted to treat the pain with a joint injection prior to performing radiofrequency ablation.
The actual procedure is performed in the outpatient setting and only requires a local anesthetic with mild sedation (optional). Once you arrive at Pain Management Associates at Hedley Orthopaedic Institute, you will be asked to change into a gown. (A sedative may be given if you’re nervous about the procedure.) In the treatment room, you’ll be asked to lie facedown on the procedure table. The skin is cleaned and a topical numbing agent is applied.
Your physician will use real-time x-ray imaging (fluoroscopy) to precisely locate the pain-bearing nerves. Next, a special needle is placed next to these nerves, and a very small amount of electricity is administered to stimulate the nerves. (This is a final test to ensure the right nerves are being treated.)
The nerves are then numbed and radiofrequency waves create a heat lesion, which disrupts the nerves so that they can no longer transmit pain signals. This entire process takes about an hour, depending on how many sites need to be treated.
How effective is radiofrequency ablation?
The success of radiofrequency ablation is closely tied to physician training and experience. This is why it’s especially important to select a fellowship-trained pain management specialist with extensive experience in radiofrequency neurotomy.
Fewer than half of all patients report significant pain relief for two years (which is generally considered the maximum length of time for which this treatment option is effective). Again, this may be due to physician experience and technique. However, even though not all patients get a full two years of relief, nearly all patients do get some degree of temporary relief (up to 12-14 months).
What risks are associated with radiofrequency ablation?
Because this back pain relief procedure does not require general anesthesia, many of the risks associated with traditional surgery or more invasive treatment options are automatically avoided. Radiofrequency ablation risks are few and far between. There is one risk you should know about, however.
In the one to two weeks following radiofrequency neurotomy, you may feel a burning sensation on the skin. This is more common when the procedure is performed in the neck (as opposed to the back). Under normal circumstances, the burning sensation is caused by the treated nerves, which are in the process of dying (usually about two to three weeks). If the pain is severe, then it could be that only a part of the nerve was damaged and the whole nerve was not destroyed; this can cause significant pain.
Many patients are concerned that having radiofrequency ablation for back pain will cause them to lose sensation and hurt themselves in some way. However, this is not a risk factor you need to worry about; there is no medical evidence to suggest that patients who have had a radiofrequency neurotomy unwittingly injure themselves.
Is radiofrequency ablation right for my back/neck pain?
For the typical patient, radiofrequency ablation is a temporary fix. Eventually, the treated nerves will regenerate and transmit sensation again. This could happen in just a few months, or it could happen after two years. Some patients will have to undergo radiofrequency ablation again or choose a different pain treatment option. In a few cases, patients do get permanent pain relief through radiofrequency neurotomy. In these patients, the nerves still regenerate. However, the pain does not return.
To find out if radiofrequency neurotomy is right for you, talk to your physician. For more information about radiofrequency ablation – or to schedule an appointment – contact Pain Management Associates at Hedley Orthopaedic Institute today. Pain management services offered in Mesa, AZ.