In the minimally invasive procedure of radiofrequency ablation (RFA), an electric current applies heat to a small area of nerve tissue to interrupt pain signals. 

Although often performed after a diagnostic facet block that pinpoints arthritic pain in the low back, radiofrequency ablations can treat other conditions as well. UM Pain specialists may use it on knees to relieve arthritis pain. In this instance, they will often first perform a genicular nerve block, which is similar to a facet block except directed at the nerves in the knees, as a diagnostic procedure to find the right area for the radiofrequency ablation treatment. It may also be used in the lower spine area to treat the pain radiating pain of sacroiliitis. 

Your pain specialist may target multiple sites, depending upon how many nerves or joints are involved. RFA is not a permanent procedure, but it may reduce or eliminate your back or neck pain for several months, up to a year, at which time the procedure can be repeated if necessary. 

Patient Information: Radiofrequency Ablation

How do I prepare for the procedure? 

Your pain management team will provide complete instructions for how to prepare. This information will include when you can eat prior to the procedure and what medications you can and cannot take. If you are diabetic, pregnant or taking blood thinners, such as Coumadin (warfarin) or Plavix, let your doctor know.

You should arrange to have someone drive you home from the procedure. 

What happens during the actual procedure? 

You will lay on your stomach in an X-ray room. If needed, An IV line may be placed to allow delivery of a mild sedative to help you to relax. We will clean the area and use a small needle to numb the area with a local anesthetic. You may feel a brief stinging or burning sensation, which will go away in about 15 seconds.

Using X-ray guidance, your doctor will insert longer needles that apply an electric current. When the needles are in place, your doctor will test them by passing a small amount of electrical current through the needles. You will feel muscle twitching or thumping for a short time, which is sometimes uncomfortable, but this testing period is brief, lasting five to 10 seconds. 

Once testing is finished, our team will heat the needles with radiofrequency waves to burn the nerves. This takes about 90 seconds. 

What will happen after the procedure? 

You will remain in our recovery area for about 20–30 minutes while we monitor your vital signs. Our pain management team will give you verbal and written discharge instructions. You may go home with your driver after your doctor authorizes discharge. 

Your pain may improve immediately, but temporarily, because of the numbing medicine. This will wear off after several hours. You may feel increased pain for several days after the procedure, including some local tenderness of the back. Use an ice pack three or four times a day to help this.

The degree of pain relief from the RFA varies from person to person. You may continue to see a decrease in your level of pain for up to three weeks as the nerve function stops.

What are the risks of the procedure? 

As with most procedures, there is a risk of bleeding, infection or allergic reaction to the medications used. Some mild short-term side effects include headache, nausea or dizziness. Rare brain or nervous system complications can occur. 

You may feel some temporary numbness or weakness in your legs or arms, depending on the location of the injection. If this interferes with your ability to walk safely, you will have to remain in the clinic until this resolves.