FAQs on Radiofrequency Ablation
Radiofrequency ablation has been one of the greatest achievements in pain management during the 21st century. It has been revolutionary with the long-standing pain relief that it is able to achieve for those with chronic neck or back pain.
What is radiofrequency ablation?
It’s a bit of a fancy medical term, but the concept is actually fairly simple. Radiofrequency ablation uses thermal energy to heat up and deaden the small nerve endings that supply sensation to painful joints.
The treatment has numerous names that refer to it, such as radiofrequency neurotomy, medial branch neurotomy, radiofrequency lesioning, radiofrequency rhizotomy and RFA.
For what conditions is a radiofrequency procedure indicated?
When a patient has chronic back pain due to spinal arthritis, radiofrequency ablation may be indicated. The spine has thumbnail size joints at every level on each side, which are referred to as facet joints. These joints may develop arthritis similar to any other
cartilaginous joints in the body like the hip or the knee.
A radiofrequency ablation can deaden the small nerve endings that supply sensation to the facet joints, known as the medial branches.
The same concept is true for those who have arthritis in the neck or mid back from spinal arthritis. The treatment works just as well.
Over last few years, radiofrequency ablation has begun to be used for sacroiliac joint related pain. In addition, RF procedures are helping with occipital neuralgia and migraine headaches, along with whiplash, pelvic pain, abdominal pain along with RSD and CRPS.
How is an RFA performed?
Patients are usually placed in a prone position, with the abdomen on a well padded table that allows x-ray beams to go through it. Modern pain management doctors in southwest Florida use fluoroscopic guidance, which is a form of real-time x-ray.
The Fort Myers pain management doctor will numb up the skin and the soft tissues down to the procedure area. At that point the doctor inserts the radiofrequency needles and will perform a test stimulation. If the person’s arm or leg jumps from the stimulation, then the needles are too close to an actual nerve root rather than the nerve endings. Once the appropriate positioning is insured, that
is when the radiofrequency thermal energy is applied. The latest radiofrequency machines allow up to four joints to be treated at one time.
Depending on where the area is being treated, either continuous or pulsed energy is applied. Also depending on the area, the temperature will vary along with the time the heat is applied. The usual settings are for 80°C for approximately 90 seconds.
Once the procedure is completed, patients are taken to the recovery room for an hour or so to monitor vital signs and to make sure no allergic reaction occurs.
How well do these procedures work?
Radiofrequency ablation procedures have been extremely successful. Overall, good to excellent results have been seen in over 75% of those undergoing the procedure with a pain relief duration averaging six to eighteen months. One study showed an average paint
relief for 470 days, which amounts to approximately 15 months. (Roy et al, J Vasc Interv Radiol. 2012 Dec;23(12):1659-64.)
Compared to a typical steroid injection, this duration of pain relief is incredible. On top of that, studies looking at repeat RF procedures when the pain relief wears off the first time have shown those procedures to produce virtually the same results. Results for both the neck and back usage are the same. (Smuck et al, Pain Physician. 2010 Sep-Oct;13(5):437-50)
Results for the sacroiliac joint have shown over 50% good to excellent results for 3 to 6 months. For migraines or pelvic & abdominal pain, studies have not been large enough to be statistically significant, but smaller studies have shown excellent results as well. (Choi et al, J Korean Neurosurg Soc. 2012 May;51(5):281-5)
What are the risks of radiofrequency ablation procedures?
The risks with these procedures are very low but real. There is a slight risk of infection, bleeding or nerve injury. If a patient is taking blood thinning medications, they should be stopped 5 to 7 days prior to the procedure. Ask your Cape Coral pain management doctor the exact timeframe.
The incidence of nerve injury is very low, however, there is the potential for the needle to be stuck in the wrong place and a nerve root to be damaged. This is why the initial stimulation is performed to make sure the needles are not close to one.
There is also a risk that for the first few weeks after the procedure, the patient’s pain may actually get worse. This is usually due to an increase in muscle spasms brought on by the procedure. Typically this settles down over a period of a couple weeks and then the real pain relief starts to kick in.
What’s the bottom line with radiofrequency ablation?
For chronic neck or back pain along with sacroiliac joint pain, headaches, chronic abdominal or pelvic pain, radiofrequency ablation has been a godsend. Prior to this procedure coming about, the duration of pain relief from these interventional treatments averaged a few weeks to a few months. Now with the invention of radiofrequency technology, pain pain relief is averaging 6 to 24 months and repeat results are showing to be excellent as well.
Radiofrequency ablation has truly been a revolutionary technology in the field of pain management. If you or a loved one is experiencing chronic neck or back pain, headaches or abdominal or pelvic pain, radiofrequency ablation may be able to help tremendously.