Understanding When Pain Management Treatment Requires Radiofrequency Ablation (RFA)

A pain management physician speaks with a patient

Chronic back pain can have multiple causes each of which profoundly impact a person’s quality of life. Through the latest advancements in pain management and pain control techniques, specialists help patients control and eliminate the cause of their symptoms to find long-lasting relief. One commonly used treatment is radiofrequency ablation, known as RFA. The pain management doctors at Centers for Neurosurgery, Spine & Orthopedics, serving patients throughout northern New Jersey, can provide insight into the procedure, its benefits, and when it would be recommended to a patient.

Benefits of Radiofrequency Ablation

Radiofrequency ablation is designed to prevent pain signals that stem from a specific branch of nerve near the spine from reaching the brain. Each level of the spine has a unique set of nerves that branch off of the spine and innervate just the corresponding joint of the spine. Through this treatment, physicians may eliminate the pain associated with this nerve branch and improve overall patient functionality. RFA will reduce the number of medications the patient needs to control their painful condition. For some, radiofrequency ablation will also delay or permanently prevent the need for spine surgery.

When Radiofrequency Ablation Is Used

Typically recommended after two successful medial branch nerve blocks, this method is considered for the benefit of its long-term pain control. Both are used to target pain in the facet joints, such as facet joint syndrome (facet radiofrequency ablation). These joints are the connections between the vertebrae in which the medial branch nerve passes through. Some of the conditions that may lead physicians to recommend an RFA procedure include:

Before scheduling an RFA appointment, the doctor should have performed a diagnostic medial nerve branch block. This is a common test used to confirm the source of the pain. It also is a key indication that RFA may be successful. If the diagnostic block fails to provide relief, the provider may recommend other treatment options.

What to Expect During the RFA Procedure

Radiofrequency ablation is typically performed in an outpatient setting. While the patient does not need general anesthesia, medication may be given to help them relax during the procedure and a numbing agent is used on the area for comfort during probe insertion.

Guided in real time through fluoroscopic imaging, a small, needle-like probe is inserted into the facet joint. Then, radiofrequency waves are sent from the probe into the targeted area, and the heat from the radio waves damages the nerves. This interrupts pain signals on their way to the brain, providing relief. For some patients, more than one nerve may be targeted during a single session.

Depending on the case, this procedure may last only 20 minutes for some patients and upward of 45 minutes for others. Most patients go home the same day and can resume normal activities after 24 hours. When the treatment plan is discussed, the physician will let the patient know approximately how long the procedure should take.

Before Diagnosing Facet Joint Disease and Care After an RFA

Physicians will perform a physical exam an imaging to confirm the diagnosis of the cause of neck or back pain. Diagnostic confirmation via local anesthetic injections beside the nerve suspected to be the source of pain must prove to alleviate the pain. Once this occurs on two separate occasions, the patient has met the criteria for an RFA which is a more permanent or longer lasting solution to the nerve causing the pain. Prior to securing authorization for the procedure, the pain management doctor will discuss this minor procedure well in advance. Some patients may be asked to avoid certain medications beforehand, such as blood thinners. Here are other things patients will be asked to do in preparation for the day of the procedure which can be done at an ambulatory surgical center or office. There will be light IV sedation provided for the procedure by an anesthesiologist:

  • Arrange to have someone drive them home after the procedure
  • Fast after midnight the evening before the procedure
  • Diabetic patients may need to adjust insulin dosage on the day of the appointment

Radiofrequency ablation recovery typically is minimal. Patients may experience soreness at the insertion site for a few days. Though extremely rare, some patients may experience complications, including infection, bleeding, or nerve damage, that may require follow-up care.

The results of this procedure vary from patient to patient. Most people experience long-lasting relief. On average, radiofrequency ablation has been proven to offer pain relief at the medial branch nerve for six to 12 months or longer.

Consult the Pain Management Physicians at CNSO

At Centers for Neurosurgery, Spine & Orthopedics in northern New Jersey, the CNSO pain management doctors are well versed in radiofrequency ablation and other pain management techniques. They discuss and educate each patient on the procedure, and other treatments including the time course of effectiveness in treating chronic pain. Contact CNSO today for more information.

Centers for Neurosurgery Spine & Orthopedics