Radiofrequency Ablation for Back and Neck Pain
Radiofrequency ablation, often shortened to RFA, is a minimally invasive procedure that eases back and neck pain by quieting the specific nerves that carry pain signals from irritated spinal joints. Using precise heat from radio waves, the procedure interrupts those signals before they reach the brain, which can bring lasting relief when medication, physical therapy and injections have not been enough. You may also see it called radiofrequency neurotomy or radiofrequency rhizotomy. At Resurgens Orthopaedics, our pain management and spine specialists perform RFA for back pain and neck pain at locations across metro Atlanta.
Overview
- What Is Radiofrequency Ablation?
- Conditions Radiofrequency Ablation Treats
- Am I a Candidate for RFA?
- What to Expect During the Procedure
- Recovery and How Long Relief Lasts
- Lumbar vs Cervical Radiofrequency Ablation
- Schedule an Appointment Today
- FAQ
What Is Radiofrequency Ablation?
Radiofrequency ablation is a pain management procedure, not surgery. Rather than opening the spine, your physician uses a thin needle guided by real-time X-ray imaging to reach the small nerves that serve a painful joint. A tiny electrode passed through the needle delivers radiofrequency energy that gently heats a short segment of the nerve, creating a small lesion that keeps it from relaying pain messages. Because it works through a needle rather than an incision, RFA typically involves little to no hospital time and often allows a quick return to normal activity.
The nerves being targeted are usually the medial branch nerves, small nerves that report pain from the facet joints. Facet joints are the paired joints that connect the vertebrae and let your spine bend and twist. When arthritis irritates a facet joint, its medial branch nerves send a steady pain signal. Calming those nerves with radiofrequency energy, a step sometimes called nerve ablation, reduces the pain the joint produces. The same approach can treat the sacroiliac joints lower in the spine by targeting their lateral branch nerves.
Conditions Radiofrequency Ablation Treats
RFA is most often used for neck, back or spine pain that traces back to the facet joints. These small joints along the back of the spine can become painful from the wear-and-tear changes of osteoarthritis, including conditions such as spondylosis, facet joint syndrome and degenerative disc disease. Facet joint ablation tends to be considered when more conservative measures like medication, physical therapy or steroid injections have provided only limited relief. The aim is simple: reduce pain, restore day-to-day function, cut back on the need for pain medication and, for some patients, help avoid or postpone surgery.
Am I a Candidate for RFA?
Radiofrequency ablation is usually considered for people whose spine or joint pain has lasted for months and has not responded to conservative care such as physical therapy, medication or other noninvasive treatments. Before recommending RFA, your physician confirms that the facet joints really are the source of the pain, typically with a diagnostic test called a medial branch block. In this test, a numbing medication is placed near the medial branch nerves. If that temporarily relieves your pain, it suggests those joints are to blame and that RFA may help. Because it avoids an incision, radiofrequency ablation can also be an option for patients who are not good candidates for surgery because of age or other health conditions. A conversation with a Resurgens pain specialist is the best way to find out whether the procedure fits your situation.
What to Expect During the Procedure
Radiofrequency ablation is an outpatient procedure that can take from 15 minutes to two hours, depending on the area and the number of nerves treated. You lie on a table while your Resurgens physician cleans the area and numbs it with a local anesthetic. Guided by X-ray imaging, the physician positions a thin needle near the target nerve, then passes a small electrode through it. Before delivering any energy, the physician may briefly stimulate the nerve to confirm the needle is in the right place, which adds a layer of safety. The electrode then sends radiofrequency energy that heats a small area of the nerve for a short time, interrupting its ability to carry pain. Your physician watches the temperature and your comfort throughout. You are awake but relaxed, and most people feel pressure rather than pain during the treatment.
Recovery and How Long Relief Lasts
Most patients go home the same day and ease back into light activity within a day or two. It is normal to have some soreness or mild numbness around the treated area at first. Pain relief is not always immediate. It often builds over one to three weeks as the treated nerves settle, and your physician may suggest physical therapy to rebuild strength and flexibility once you are comfortable. When RFA works, relief can last from six months to 12 months, and sometimes longer. Treated nerves do slowly regrow over time, so pain can gradually return, and radiofrequency ablation can be repeated if it helped before.
Please Note: Call your physician if you notice fever, increasing redness, swelling or drainage at the injection site, or new weakness or numbness in an arm or leg after the procedure.
Lumbar vs Cervical Radiofrequency Ablation
The same technique is used whether the pain is in the lower back or the neck, but the two areas call for different precision. Lumbar radiofrequency ablation treats the medial branch nerves of the lower back, where the larger anatomy gives the physician a bit more room to work. For the procedure, you lie face down with a pillow supporting your hips.
Cervical radiofrequency ablation treats the nerves of the neck and can also help the headaches that start in the neck, known as cervicogenic headaches. The neck is a tighter, more delicate area with important structures nearby, so needle placement must be especially precise. For this procedure, you lie face down with your neck gently flexed forward. Learn more about cervical facet radiofrequency neurotomy.
Schedule an Appointment Today
If back or neck pain is affecting your life, help is within reach. Book an appointment online today with Resurgens Orthopaedics or call us at (404) 847-9999.
FAQ
Is radiofrequency ablation painful? Most people feel pressure rather than pain during RFA, since the area is numbed first. Mild soreness for a few days afterward is normal.
How long does radiofrequency ablation last? Relief commonly lasts several months to a year or more. Because the treated nerves slowly regrow, the procedure can be repeated if your pain returns.
Is RFA the same as nerve ablation or radiofrequency neurotomy? Yes. Radiofrequency ablation, radiofrequency neurotomy, radiofrequency rhizotomy and nerve ablation all refer to the same procedure.