Chronic back or neck pain caused by nerve damage can seriously affect a patient’s quality of life. For patients who do not experience pain relief from oral medication but do experience relief from a facet joint injection, also known as a medial branch block (MBB), a procedure called radiofrequency ablation (RFA) will help. Learn more about how RFA provides long lasting pain relief from Centers for Neurosurgery, Spine & Orthopedics, New Jersey’s most comprehensive center for diagnosing and treating back pain.
What is RFA?
When irritation to the medial nerves within the facet joints is the source of pain, an RFA, also called a rhizotomy, is a nonsurgical procedure that uses radiofrequency waves to heat up and interrupt the pain signals that are being generated. The precise delivery of radiofrequency waves can ablate an inflamed or irritated nerve, thereby stopping the transmission of pain signals to the brain.
Because RFA is minimally invasive, patients can undergo treatment without having to take a day off from non-labor work. Patients have no need for oral pain medication afterward. If pain returns after 6 months or longer an RFA procedure can be repeated to address the regrown of the same offending medial nerve.
Before recommending RFA, a pain specialist must perform a diagnostic nerve block to confirm whether a rhizotomy will be an effective treatment method. As per all medical guidelines, the patient must experience nearly 100% pain relief from the diagnostic block on two separate occasions. Only then can an RFA be performed once the pain returns the third time. An RFA should be coupled with physical therapy so the patient can immediately begin strengthening the back muscles that they have avoided using because of the pain for so long.
Conditions That Can Be Treated With RFA
RFA can offer longer-term relief than oral medication or injection treatments. Rhizotomy can treat nerve pain caused by various conditions, including:
- Facet joint disease: Caused by degeneration of the intervertebraljoints, facet joint disease can lead to inflammation that triggers pain signals in surrounding nerve endings.
- Medial branch nerve: A pinched or compressed medial branch nerve in the facet joint can cause chronic back pain.
- Radiculopathy: This condition occurs when a spinal nerve root is damaged or pinched and can cause weakness, numbness, and back or neck pain.
- Sacroiliitis:Inflammation of the sacroiliac joints where the spine connects to the pelvis can lead to nerve pain.
- Spondylosis: A general term for arthritis of the spine, spondylosis often occurs as the result of normal wear and tear on the spinal vertebrae.
- Trigeminal neuralgia: This extremely painful condition causes stabbing facial pain that feels like electric shocks. It is caused by irritation of the trigeminal nerve.
How Does the Procedure Work?
Before a patient undergoes RFA, their doctor will provide information about how to prepare. This may include fasting beforehand or avoiding certain medications. The patient typically will receive an intravenous (IV) line to deliver sedation medication during the procedure. This procedure does NOT require general anesthesia.
Using fluoroscopy (X-ray) guidance, a doctor will guide a needle to the source of the patient’s nerve pain. Using a tiny electrode inside the needle, a radiofrequency current will destroy a small amount of nerve tissue. The entire procedure usually takes just a few minutes.
Afterward, the patient will be monitored in a recovery area for approximately 30 minutes then be cleared to go home. They will need someone to drive them home and should take a day to rest and recover. Some patients experience mild bruising, pain, or swelling at the injection site.
Efficacy and Frequency of Treatments
Each patient is different – some feel immediate relief, while others take longer to see results. Cleveland Clinic reports that RFA pain relief can last from six months to several years, depending on the patient. Nerve endings can grow back, so a patient may need more than one RFA procedure over time. Generally, RFA can be repeated six to 12 months after the initial procedure, after the nerve ending has had time to regrow.
Learn More About RFA From CNSO
For some patients, facet radiofrequency ablation can be an effective treatment for long-term pain management. At Centers for Neurosurgery, Spine & Orthopedics, patients in northern New Jersey and the surrounding area can receive RFA and other treatments from an award-winning team of pain management specialists. Taking a comprehensive approach to care, the physiatrists, neurosurgeons, and orthopedic spine surgeons at CNSO locations work in collaboration to treat neck and back pain while addressing the underlying causes. For more information, contact CNSO today.