Radiofrequency Ablation

Facet joints are small joints located in pairs on the back of the spine that run from the top of the neck to the bottom of the low back. Medial branch nerves are the tiny nerve branches that innervate these joints and communicate pain caused by these joints to the brain.

If you have had a temporary or “diagnostic” response to an initial and a confirmatory medial branch block, your physician may recommend a radiofrequency ablation for treatment. This procedure involves delivering a precise heat lesion or “burn” to the medial branch nerve so that it does not effectively transmit pain from the facet joint, which results in decreased pain and increased function.

What is Radiofrequency Ablation?

Radiofrequency ablation is a minimally invasive medical procedure that uses heat to destroy targeted tissue. In pain management, radiofrequency ablation targets specific nerves called medial branches that innervate the facet joints. The heat generated disrupts the nerve’s function, preventing it from transmitting pain signals to the brain. This can provide long-term pain relief for chronic pain conditions, especially arthritis in the back and neck joints, when other methods haven’t been successful.

The Benefits of Radiofrequency Ablation

Radiofrequency ablation targets the nerves that transmit pain signals from the facet joints in your spine to your brain. The goal is to disrupt the function of these specific medial branch nerves that supply sensation to the facet joints.

Radiofrequency ablation offers several benefits, particularly for those experiencing chronic back or neck pain:

• Long-Term Pain Relief: While the pain relief from radiofrequency ablation is not permanent, it can offer significant pain relief for extended periods compared to steroid injections. Studies estimate the pain relief to last from nearly one to two years. In some patients the relief can last much longer.
• Minimally Invasive: Because radiofrequency ablation is performed with a needle under fluoroscopic (x-ray) guidance, this procedure results in less scarring and quicker recovery than surgery.
• Outpatient Procedure: We perform radiofrequency ablation on an outpatient basis in an in-office procedure room.

The Radiofrequency Ablation Procedure

• An IV may be started so that relaxation and pain medication can be given.
• You will lie face down on a procedure table.
• The physician will use fluoroscopic (X-ray) guidance to visualize the spine.
• The physician will scrub your skin with sterile soap, place a drape on your back, and numb an area of skin with anesthetic medication.
• After the anesthetic has been given time to be effective, the physician will then direct a special needle using fluoroscopic guidance towards the medial branch nerve.
• After the needle is in its proper location, your physician will inject a small amount of anesthetic medication and then “burn” the medial branch nerve for ninety seconds via a probe inserted into the needle..
• This procedure may be repeated at one or more levels, depending on the location of your typical pain.

Pre-Op and Post-Op Instructions

Before the Procedure

• You will be scheduled at one of our convenient locations, listed below, where you will be for approximately 1 hour total.
• You will be required to have a responsible adult drive you home.
• You should take your routine medications (i.e., blood pressure and diabetic medications) on the day of your procedure.
• If you are taking a blood thinner and are having a cervical procedure, please notify the office immediately.
• You must not eat any food six hours before your appointment.
• You may have sips of clear liquids up to two hours before your appointment.
• Wear loose, comfortable clothing to your appointment.

After the Procedure

Immediately after the procedure, you will go to a recovery area where you will be monitored for approximately 15-30 minutes. Of note, depending on the area treated, the arm(s) or legs(s) may feel weak or numb for up to a few hours after the procedure. You will not be allowed to drive on the day of the procedure if you have had sedation.

Plan to relatively rest for the remainder of the day after the injection. Avoid strenuous activities and heavy lifting. Light walking and gentle stretching are encouraged to promote circulation and healing. If you have had sedation, you may return to your normal activities the day after your procedure, including returning to work.