Radiofrequency ablation is used independently or in combination with other pain management procedures to ensure prolonged pain relief. It helps minimize pain in the cervical and lumbar spine if you have a positive response to either medial branch blocks or facet injections. It is a minimally invasive procedure that is typically, accepted by most insurance companies as a way to manage painful conditions.
What is radiofrequency ablation?
Radiofrequency ablation involves the use of radio waves to disrupt conduction of pain signals. Electromagnetic heat produced by radio waves destroys or stuns nerves limiting their ability to their carry pain signals. About 500,000 pulses of the radio wave are administered per second keeping the temperature between 45 and 70 degrees. This only “shuts off” the nerves without damaging them and disables pain sensation transmission by them over a long period of time.
How does radiofrequency ablation ensure pain relief?
Radiofrequency ablation ensures controlled heating through short pulses that stuns and confuses nerves and makes them senseless. The method acts as a nerve block preventing nerves from carrying pain signals. As a result, the pain conduction is interrupted and stopped.
What are benefits of radiofrequency ablation?
Radiofrequency ablation is used to reinforce nerve blocks performed to reduce pain conditions. It reinforces the treatment and almost doubles the duration of pain relief. Pain relief continues to be there even after the numbing medication wears off. The therapy is also used as a standalone mode of treatment to block facet and medial nerves involved in pain transmission.
Radiofrequency ablation is found to be helpful in managing pain related to spinal injury, facet syndrome, and arthritis in vertebral joints.
What are conditions treated using radiofrequency ablation?
- Chronic neck and back pain
- Reinforcing results of celiac plexus block, ganglion impar block, medial branch block, sphenopalatine block, stellate ganglion blocks
- Facet joint syndrome pain in the back and neck
- Atypical facial pain
- Pain from arthritis of the spine
- Pain due to peripheral nerve damage
- Facial pain due to neuropathic disorder
- Facet joint disease causing neck and back pain
- Sacroiliac joint dysfunction pain
- Pain due to vertebra deformity
- Abdominal pain associated with visceral nerves
How effective is radiofrequency ablation?
- Multiple studies attest efficacy of radiofrequency ablation in managing pain from occipital neuralgia (Clinical Neurology and Neurosurgery, 2007), sacroiliitis and discogenic pain (Anesthesiology, 2008),
- The procedure helps stop cervicogenic face and head pain (Clinical and Experimental Rheumatology, 2000).
- According to the Pain journal, the therapy prolongs knee pain relief. (Pain, 2011)
- A study claimed moderate to complete relief from neck and back pain following treatment using radiofrequency ablation. (Pain Practice, 2005)
- The procedure is 92 percent effective in subduing pain from trigeminal neuralgia (Arquivos de Neuro-Psiquiatria, 2001) and also inhibits spinal and nerve root pain successfully (Best Practice & Research in Clinical Anaesthesiology)
How Is Radiofrequency Ablation done?
Radiofrequency ablation is performed under local anesthesia. Patients lay on an x-ray table and a needle is inserted into the skin at the place of pain with fluoroscopic assistance. The area is numbed prior to the needle insertion.
A contrast dye is put through the needle to make sure it is at the targeted place. Then, a microelectrode is put through the needle. Patients are asked if a tingling sensation is present after the microelectrode is placed. The procedure can then be completed.
How long does it take?
Radio waves are administered for about 90 seconds and the entire procedure takes about 30 minutes. The patient is discharged after being monitored for another 30 minutes.
What should I expect after radiofrequency ablation?
Patients may experience temporary soreness at the injection site. Rest is suggested after the procedure.
How long do the benefits of radiofrequency ablation last?
On an average, radiofrequency ablation following nerve block injections allows relief from pain up to 24 months. There are several instances when the pain relief is visible beyond this for many years.
How many radiofrequency ablations should I have?
Consult with your doctor to know the suitability of having repeat radiofrequency ablation. It is subject to patient condition and overall response.
What Are The Side Effects of Radiofrequency Ablation?
Except for short-term soreness at injection site, occasional bleeding can occur. The area over where the procedure is performed may be numb. The radiofrequency ablation procedure is well tolerated. Unless you have an expert doctor, there may be chances of motor nerve damage, blood vessel rupture, spine injury and electrical burn.
References
Tekin I, Mirzai H, Ok G, et al.: A comparison of conventional and pulsed radiofrequency denervation in the treatment of chronic facet joint pain. Clin J Pain. 2007; 23 (6):524-529.
Sphenopalatine ganglion pulsed radiofrequency treatment in 30 patients suffering from chronic face and head pain. Bayer E, Racz GB, Miles D, Heavner J. Pain Pract. 2005 Sep;5(3):223-7
Lord SM, Bogduk N. Radiofrequency procedures in chronic pain. Best Pract Res Clin Anaesthesiol. 2002 Dec;16(4):597- 617.
Cohen, S., Hurley, R., Buckenmaier, C., Kurihara, C., Morlando, B., Dragovich, A., Randomized placebo-controlled study evaluating lateral branch radiofrequency denervation for sacroiliac joint pain. Anesthesiology, 2008; 109: 279-287.
Choi WJ, Hwang SJ, Song JG, et al. Radiofrequency treatment relieves chronic knee osteoarthritis pain: a double-blind randomized controlled trial. Pain. 2011; 152: 481-7.
Arora R. Radiofrequency neuroablation in chronic low back pain. Practical Pain Management. 2005 March;18-20.
