Radiofrequency ablation (RFA) is a medical procedure that uses high-frequency electrical current to cauterize or ablate structures within the body.
IS RADIOFREQUENCY ABLATION RIGHT FOR ME?
WHAT CONDITIONS DOES IT TREAT?
One of the most common uses of radiofrequency ablation is to treat spine pain that is caused by arthritis of the facet joints (spondylosis) in lower back, mid-back, or neck.
WILL RADIOFREQUENCY ABLATION HELP MY BACK PAIN?
If you have facet joint pain, then Radiofrequency ablation is very likely to help reduce your back pain and improve your activity level. Symptoms of facet joint pain include pain in the low back that may radiate to the buttocks and the thighs. Often the pain will be worse with twisting and bending backwards. Your physician will usually confirm that pain is from the facet joints by performing a facet joint injection or a medial branch block. If either of these injections is successful, even for a short period of time, then a Radiofrequency ablation is likely to reduce your pain for at least 6 months and possibly quite a bit longer.
HOW DOES RFA WORK TO CONTROL MY PAIN?
The prevailing theory on RFA is that it decreases the nerve’s sensitivity to transmitting pain signals back to the spinal cord, which means that fewer pain signals travel up to the brain. This means that you will feel less pain, since pain is actually felt by the brain. If there is no signal for the brain to feel, then your pain level will be lower. The technical term for this is hyper-polarization of the nerve. Eventually, the nerve returns to normal and then the pain comes back. When this happens, the RFA can be repeated. In general, pain relief from RFA lasts 6-24 months.
PREPARING FOR TREATMENT
WHAT SHOULD I EXPECT DURING THE PROCEDURE?
RFA is performed with the patient laying in the prone position on the procedure table. Your physician will then use an X-ray camera (called a fluoroscope) to look at your spine. He or she will then numb the skin using Lidocaine. Once you are numb, your physician will place a small needle through the skin and guide it to the location of the facet joint nerve (the medial branch or paravertebral nerve). Once in the correct spot, the location will be tested for accuracy. This test passes a small amount of electrical energy through the nerve and may feel a little bit like a TENS unit or an E-stim for a few seconds. After this, the nerve will be numbed with Lidocaine or Marcaine, and then the nerve is treated with Radiofrequency energy for 60-90 seconds. The needle is then removed.
WHAT CAN I EXPECT AFTER THE PROCEDURE?
It is common to be sore for a couple of days after the procedure. Ice, anti-inflammatories, and rest can help with this. The pain relief after the procedure may be immediate, but it usually takes about a week or 2 before you will feel less pain.