Radiofrequency ablation, also known as RFA is a minimally invasive procedure performed in an outpatient clinic to treat neck, back, facet joints, and sacroiliac joint pain. It involves the use of radio waves pulsing at a high frequency that temporarily disable the nerves from transmitting pain signals to the brain. Relief can last three to six months. Radiofrequency ablation treatment could be an option to manage chronic back and neck pain. There are other names, but the radio frequency concept is the same. They are:

• Pulsed radiofrequency ablation
• RF ablation
• Radiofrequency lesioning
• Radiofrequency neurotomy
• Radiofrequency rhizotomy

Chronic neck, back, and hip pain take a significant toll on the body. Finding the right treatment can make all the difference. However, it does not work for everyone. For those that might have tried other non-surgical treatments to manage the pain, including physical therapy and steroid injections, that did not bring relief then radiofrequency ablation could be another treatment option.

Radiofrequency Ablation Benefits

• Pain relief compared to steroid injections lasts longer
• Relief exceeds that of injections
• It is a non-surgical procedure
• Complication risks are low
• Opioid or other analgesic medication is reduced
• Quick recovery
• Improved quality of life
• Relief can last six months to a year, and longer

Pain Reduction

Before undergoing radiofrequency ablation, a doctor must pinpoint the nerves causing the neck, back, or sacroiliac joint pain. They will perform a nerve block injection to determine if there is temporary relief from the pain. If there is temporary relief it means that the origin of the pain was found. This could qualify to become a candidate for radiofrequency ablation.

• A Medial branch block is performed to diagnose the facet joint/s that are causing the pain.
• A sacroiliac joint block is performed to determine if and which sacroiliac joint is causing the pain.

Preparation

The doctor will give instructions on how to prepare for the procedure. Instructions can vary from those listed, as every patient’s case is unique.

• Do not eat 6 hours prior to your procedure
• Wear loose, comfortable clothing
• Easy to put on shoes
• Have a designated driver for after the procedure
• Make sure the doctor knows about all medications, vitamins, supplements, and herbs being taken
• Follow the doctor’s instructions when taking prescribed and over-the-counter medications. This includes vitamins, supplements, and herbs
• Bring all medications on the day of the procedure to be taken with minimal interruption

Radiofrequency ablation usually takes an hour or longer depending on the extent of the treatment. One example could be the number of facet joints being treated.

The Procedure

The patient will be positioned face down on the treatment table. Pillows are offered and positioned for optimal comfort. The area where the treatment will be administered is sterilized. The areas of the body not undergoing the treatment are covered with a sterile covering. Sedation could be utilized but not heavy sedation. More than likely it will be what is known as twilight sedation.

A local anesthetic is injected into and around the area/s being treated. Because radiofrequency ablation involves electricity a grounding pad is attached to the calf of one of the legs. The treatment table is adjusted for the precise placement of the needles and electrodes. The doctor will use fluoroscopy or a real-time x-ray as a guide.

Once the needle/s and electrode/s placement is confirmed, a low electrical current is sent through the electrodes. This creates waves of pulsating energy that stimulate and change the nerve/s sensory tissue so it does not send pain signals. Some individuals report a warm or mild pulsing sensation. When finished, the electrodes and needles are removed. The treated area is cleaned up, sterilized and bandages are applied.

After the Procedure

After the procedure, the patient is sent home with a set of recovery instructions. An example could be:

• Keep the bandages in place
• Don’t take a bath or shower
• A shower can be taken the following day and the bandages removed
• Do not perform any strenuous activity for up to two days

When the anesthetic wears off, the individual will have soreness and some mild pain around the treatment area. As long as everything is fine individuals can return to work and normal routine within three days. Full recovery can take up to two weeks for the treated/ablated nerves to stop sending pain signals. Although the nerves no longer conduct pain, it is temporary and not a permanent fix. This is because the nerves grow back. If the cycle starts over, talk with the doctor about another session.

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