Radiofrequency Ablation (RFA) is a minimally invasive pain management technique used to provide long-term relief from chronic spinal, joint, or nerve-related pain. It works by using controlled radiofrequency energy to heat and deactivate the small sensory nerves that transmit pain signals from specific joints or structures — most commonly the facet joints, sacroiliac joints, or medial branch nerves. RFA does not damage muscles or motor nerves, and can relieve pain for 6 to 12 months or longer, significantly improving quality of life and mobility.
Indications
RFA is typically recommended for patients who have had successful temporary pain relief after diagnostic injections such as:
- Facet joint blocks (for neck or back pain)
- Medial branch blocks (for facet-mediated pain)
- Sacroiliac joint blocks (for buttock or lower back pain)
- Chronic post-surgical pain or spinal degenerative disease
- Occipital neuralgia or selected peripheral nerve pain
RFA is especially beneficial when inflammation and pain return after steroid injections, but surgery is not yet indicated.
Mechanism
The procedure uses a radiofrequency generator that delivers a small electrical current through a fine needle to the target nerve. The heat energy (typically 80°C for 60–90 seconds) creates a controlled lesion on the sensory nerve, interrupting pain transmission while preserving movement and strength. Pain relief develops gradually over 1–3 weeks as the nerve stops carrying pain signals.
Procedure
1. Preparation
- Performed in an outpatient setting, usually under local anesthesia with mild sedation if needed.
- The patient lies comfortably while fluoroscopy (X-ray) is used to guide the needle with precision.
- A small amount of contrast dye ensures correct placement near the target nerve.
2. Stimulation and Lesioning
- Before ablation, a brief test stimulation confirms correct nerve location by reproducing typical pain or mild tingling.
- After confirmation, local anesthetic is injected for comfort.
- The radiofrequency current is then applied for 60–90 seconds to selectively disable the pain-transmitting nerve.
3. Post-Procedure Care
- Patients are observed for 15–30 minutes and can usually return home the same day.
- Some soreness or bruising at the needle site may occur for a few days.
- Normal activities are typically resumed the next day.
Expected Benefits
- Long-lasting pain relief (6–12 months or longer)
- Improved mobility and physical function
- Reduced dependence on pain medications
- Better participation in physiotherapy and daily activities
- Repeatable if pain returns as the nerves regenerate over time
Risks & Complications
RFA is considered very safe when performed by experienced specialists. Possible but uncommon side effects include:
- Mild temporary pain or burning at the injection site
- Numbness or tingling lasting a few days
- Allergic reaction to local anesthetic or medication
- Very rare: infection, bleeding, or nerve irritation
Permanent complications are extremely rare.
Recovery & Follow-Up
- Mild soreness may last 2–3 days; ice packs and mild pain relievers can be used.
- Gradual pain relief develops over 1–3 weeks.
- Follow-up appointments assess pain reduction and physical improvement.
- In some cases, repeat RFA may be scheduled after 9–12 months if pain recurs.
- Patients are encouraged to continue core strengthening, stretching, and physiotherapy to maintain spinal health and prolong benefit.
Patient Advisory
Radiofrequency ablation is most effective when diagnostic nerve blocks have confirmed the pain source. Not all spinal or joint pain is suitable for RFA — precise evaluation by your neurosurgeon or pain specialist is essential. Results vary depending on the underlying cause, anatomy, and individual healing response. Do not rely solely on online information to decide treatment; consult your treating physician for personalized recommendations.