Radiofrequency ablation is a procedure that utilizes radio waves to interrupt nerve fiber transmission for a prolonged period of time. The typical duration of relief is usually 6-9 months.
You will first undergo a diagnostic nerve block (numbing of a specific nerve) to isolate the nerve that is generating your pain. The most common use of radiofrequency ablation is for facet joint disease.
The length of the procedure will depend on the number of nerves to be treated. Generally, the procedure will last between 30-60 minutes.
The procedure is performed in a procedure room with fluoroscopy (x-ray) in a clean environment.
We will use numbing medicine to numb the skin and tissues underneath. We will stimulate through the needle probe before starting the burning of the nerve. During this part, you may feel a buzzing or bouncing sensation in your back. After the nerve is localized, we will heat up the needle tip for about 2 minutes.
No. The safest way to do this procedure is under local anesthesia. You may choose to have intravenous sedation, which will help you relax, but you will always be awake during the procedure to minimize the chance of any nerve damage.
You will be lying on your stomach for lumbar facet joints or lying on your back for cervical facet joints on an x-ray table. You will be monitored with a blood pressure cuff, EKG, and pulse oximetry. When the injection is complete, you will move to a recovery bed lying on your back.
You may have a sore back for up to a week after the injection. Some patients have immediate relief after the injection but the majority will take several weeks before achieving full benefit.
We recommend that you limit strenuous physical activity the day of the injection. You will bring someone with to drive you home the day of the injection. There is absolutely no driving the day of the injection. You may go about your normal daily activities as tolerated excluding strenuous physical activity.
You have no limitations for returning to work the next day. Most patients will have some residual soreness for 1-2 weeks.
This is a semi-permanent procedure, so over time, the nerves will regenerate. The effects can last anywhere from a few months to years.
When the effects of the first procedure wears off, it may be recommended for you to have a second procedure. This is determined by the amount and duration of benefit you received as well as alternative treatments available.
Overall, the procedure is very safe. As with any procedure, there are risks. The most common side effect is pain, which is temporary. Any time a needle is punctured through the skin, there is a chance of bleeding or infection that is very rare. Other rare side effects include spinal headache, nerve damage, worsening of pain, etc., which are extremely unlikely.
If you are allergic to specific local anesthetics or ionic contrast, please notify your physician. Also, if you are taking any blood thinners (Coumadin, Plavix, Warfarin, Lovenox, Aspirin, etc,) please let your physician know ahead of time to help devise a safe plan for the injection.