FAQ’s on Radiofrequency Ablation
What is Radiofrequency Ablation?
Radiofrequency ablation (RFA) is a rather new technique that has provided a revolutionary tool in pain management as a method of treatment for patients with chronic pain in the neck or back. RFA is the careful, controlled destruction of a problematic nerve ending to provide an extended period of relief to patients with chronic nerve pain. With advances in RFA technology, the capabilities of the procedure are enormous when it comes to providing near-permanent pain relief.
What will Radiofrequency Ablation treat?
There are a number of conditions that previously did not have reliably methods of permanent relief that are treatable with an RFA procedure. One of the most commonly treated conditions in our patients is degenerative facet arthritis of the lumbar spine in cases where a nerve has been irrevocably damaged. Cervical facet arthritis is another chronic condition readily treatable with RFA.
Cervical and lumbar pains have the two most tested and reliable RFA procedures, with other areas currently in the experimental stage of treatment. Pain due to chronic arthritis of the sacroiliac joint, and pain due to the occipital nerves each have RFA procedures currently being tested. It is entirely possible to develop an RFA procedure for any nerve that has become the root source of chronic pain for a patient.
How is Radiofrequency Ablation performed?
RFA is normally performed inside of a dedicated treatment center, but does not require an extended stay for patients. Performed as an outpatient procedure, patients will typically be given intravenous sedation but it is not mandatory. Those patients who chose to remain conscious will be given painkillers and the area surrounding the nerve to be treated will be numbed fully. Following numbing, the site to be injected is sterilized.
Once prepared, an RFA probe (similar to a needle) will be guided to a position close to the nerve with fluoroscopic imaging. Fluoroscopic imaging uses a series of rapid X-rays to create an image of where the needle currently is. After the probe has been positioned beside the intended nerve, the physician will stimulate the needle. If a patient reacts, the needle has been placed too close to the intended nerve and must be re-positioned to avoid damaging the nerve (ablation seeks only to destroy the pain-causing nerve endings, not the nerve itself).
If no reaction occurs, carefully controlled heat will be applied to deaden the nerve endings that were causing a patient pain.
How well does Radiofrequency Ablation work?
Many treatments deal with periods of relief lasting only weeks or a small number of months. RFA deals with treatments lasting between one and two years. The single reason that RFA is not able to provide relief on a permanent basis is that nerve endings can re-grow after time. The RFA can then be repeated to deaden them once more. In many cases, repeat RFA procedures are able to provide the a higher degree of pain relief for a longer amount of time.
There is small risk of infection, bleeding, or soreness at the site of injection of the RFA probe. There is also a small risk of the probe being misplaced before being stimulated, which may cause pain for the patient. While trial stimulation is preformed to ensure this does not occur, there is still the chance for the needle to move in an unintended manner during the procedure.
The single largest risk is that RFA may not be able to provide relief to patients after deadening the problematic nerves.
What is the bottom line of Radiofrequency Ablation?
Patients who experience a successful RFA are able to achieve a high level of relief for an extended duration of time.