Radiofrequency Ablation Treatment for Neck, Back and Sacroiliac Pain
Minimally invasive treatment option to manage chronic back and neck pain
Radiofrequency ablation (RFA) is a minimally invasive treatment performed on an outpatient basis to treat painful neck or back facet joints or sacroiliac joint pain. The treatment involves use of pulsed radio waves produced at a high frequency that temporarily stun/disable nerves from transmitting pain signals to the brain. Pain relief may last 3-6 months. This treatment goes by many other names, but the concept is the same.
• RF ablation
• Pulsed radiofrequency ablation
• Radiofrequency rhizotomy
• Radiofrequency neurotomy
• Radiofrequency lesioning
Chronic neck and/or back pain is frustrating. Besides the obvious pain, it can be challenging to find the right treatment. What worked like magic for one person may have no effect on you. You might have tried other nonsurgical treatments to manage your pain, including physical therapy and epidural steroid injections. If those methods fail, radiofrequency ablation may be considered.
Potential Benefits of Radiofrequency Ablation
- Better and longer-lasting pain relief compared to steroid injections
- Minimally invasive, nonsurgical procedure
- Risk for complications is low
- Reduced need for opioids or other analgesics
- Recovery is quick, quality of life is improved
- Relief may last six months to a year, sometimes longer
Will radiofrequency ablation reduce your pain?
Before you’re able to undergo radiofrequency ablation, your doctor must first pinpoint the nerves causing your neck, back or sacroiliac joint pain. He or she will do this by performing a nerve block injection to determine if it temporarily reduces your pain. If it does, that means your doctor found the origin of your pain, and you may be a candidate for RFA.
- Medial branch blocks are performed to diagnose the facet joint(s) involved
- Sacroiliac joint block is performed to determine if/which SI joint is pain provoking
Preparing for Radiofrequency Ablation
Your doctor will give you instructions on how to prepare for your treatment. Keep in mind that each patient’s needs are different, so your instructions may vary from those listed here.
- Dress in loose, comfortable clothes, slip on shoes
- Leave jewelry and valuables at home
- Ask someone to drive you home after the procedure
- Do not eat 6 hours prior to your procedure
- Be certain your doctor is aware of all medications, vitamins, supplements and herbs you take
- Follow your doctor’s orders regarding taking prescribed and over-the-counter drugs, including vitamins, supplements and herbs
- Bring all medications with you on the day of the procedure so you can take them with minimal interruption.
Radiofrequency ablation typically takes one hour or longer depending on the extent of your treatment (eg, multiple facet joints).
How is radiofrequency ablation performed?
More than likely, you will be positioned face down on the procedure table. Pillows are positioned for your comfort. The skin area where treatment will be administered is cleansed using a sterilizing solution. Areas of your body not involved in treatment are dressed with sterile covers (eg, sheet).
A local anesthetic is injected into and around the areas to be treated. A grounding pad is attached to the calf of one of your legs, as radiofrequency ablation involves electricity. Next, the treatment table is adjusted to allow precise placement of the needles and electrodes using fluoroscopy (real time x-ray).
After needle and electrode placement is confirmed, an electrical current is passed through each electrode creating on/off pulsating waves of energy that stuns and changes the nerve (sensory) tissue so it cannot transmit pain signals. Some patients report feeling warmth and/or a mild thumping sensation in the treatment areas.
When the radiofrequency ablation process is finished, the electrodes and needles are removed. The skin area is cleansed, and small bandages are applied.
What to Expect After the Procedure
You are allowed to return home after radiofrequency ablation as it is performed on an outpatient basis. Keep the bandages in place and do not swim, take a bath, or soak. You can take a shower the following day and remove the bandages then. Do not perform any strenuous activity for a day or two. As the anesthetic wears off, you may feel sore and have pain in the treated area. Most people are able to return to work and their normal routine within three days.
It can take upwards of two weeks for the ablated nerves to stop sending pain signals. If the pain is bothersome or interfering with your daily life, talk to your doctor about an appropriate analgesic.
While radiofrequency ablation disables nerves from conducting pain, the solution is not permanent as the nerves will grow back. If the cycle of pain begins again, you can talk with your doctor about undergoing RFA again.