Pain Management

July 11, 2022

How Radiofrequency Ablation Relieves Chronic Pain


Radiofrequency ablation uses radio waves to destroy nerve tissues that send pain signals to the brain. It’s a treatment option for chronic, or long-term, pain that hasn’t responded to other methods.

What is Radiofrequency Ablation?

Also known as rhizotomy, radiofrequency ablation is a non-surgical, minimally invasive procedure. It uses heat from radio waves to stop or reduce the transmission of pain. The radio waves burn, or ablate, the pain nerve, eliminating the source of pain signals to the brain.

Radiofrequency ablation involves the insertion of a small, hollow needle into the targeted nerve that’s causing the pain. An electrode is inserted at the top of the needle to send radio waves to the targeted nerve. The heat from the radio waves causes a lesion, which prevents the targeted nerve from transmitting pain signals to your brain. Healthy nerves are not damaged during this procedure.

What Are the Goals of Radiofrequency Ablation?

The goals of radiofrequency ablation include:

  • Stopping or reducing pain
  • Improving function
  • Decreasing the need for pain medication
  • Avoiding or delaying surgery
  • Helping you return to regular activities after resting for a day or two

Who Needs Radiofrequency Ablation?

People with chronic pain that have not responded to pain medication and physical therapy may receive this treatment. Patients who experience pain relief from nerve blocks will likely benefit significantly from radiofrequency ablation.

Radiofrequency ablation can be used for conditions such as:

  • Pain in your knee, back, or neck
  • Peripheral nerve pain (pain in the limbs)
  • Cancer pain
  • Sacroiliac joint pain
  • Arthritis of the spine (spondylosis)
  • Facial pain
  • Heart rhythm issues

Because radiofrequency ablation involves fluoroscopic (x-ray) guidance, pregnant patients and those with bleeding problems or an infection should not undergo the procedure.

What Happens Before a Radiofrequency Ablation Procedure?

Before undergoing radiofrequency ablation, you will need to have a consultation with a pain specialist to make sure this procedure is correct for you. A pain management physician at Arkansas Surgical Hospital will review your medical history regarding your pain. You will be interviewed about your condition and will need to undergo some imaging tests, including x-rays. These tests will help determine the degree of your pain and its exact location. They will also rule out contraindications to make sure that it’s safe for you to undergo the procedure.

Your pain specialist will perform a nerve block test to confirm the location of the pain and its severity level. The nerve block is administered as a local anesthetic injection near the painful area. If relief occurs with this injection, you will benefit from radiofrequency ablation, and your pain doctor will schedule the procedure. However, if the nerve block isn’t effective, other treatment options will need to be considered.

How Do I Prepare for Radiofrequency Ablation?

Once the procedure is scheduled, you will need to make arrangements for transportation and availability. Your doctor will give you directions on what to do in the time leading up to the ablation, such as reducing or stopping certain medications. For example, you may need to stop taking aspirin or other blood-thinning drugs several days before the procedure.

What Happens During Radiofrequency Ablation?

A radiofrequency ablation procedure can last from 15 minutes to two hours, depending on the severity and location of your pain and how many treatments are required. The procedure involves the following steps:

Step 1: Patient Preparation

You will be placed on a unique x-ray table in your procedure room, lying on your stomach. A local anesthetic will be applied to numb the area where the needle will be inserted. A low-dose sedative is given, but you’ll be awake and aware throughout the treatment process to give feedback to your doctor.

Step 2: Needle Insertion

A thin, hollow needle is inserted into the painful region with the aid of a special x-ray tool called a fluoroscope. The fluoroscope allows the physician to watch the needle on a monitor in real time to ensure it goes to the desired location. Your physician may also inject contrast to confirm the needle’s location. Discomfort may occur, but it feels more like pressure than pain.

Step 3: Heat Delivery

After the needle is inserted, you will be given numbing medication. Then, the radiofrequency current is passed through the needle to create a small, precise burn—about the size of a cotton swab tip—on the painful nerve. The current destroys the nerve transmitting your pain and disrupts the production of pain signals. Multiple nerves can be ablated simultaneously, with each one taking about 90 seconds.

What Happens After a Radiofrequency Ablation Procedure?

After the treatment, you can go home following a brief recovery period. Most people start walking immediately after the treatment, but because of the sedative, you will need someone to help you get home.

Your doctor will advise you not to do strenuous activity, including driving, for up to 72 hours after the treatment. After that, you can usually return to regular activities, including working and bathing.

You may experience pain, soreness, or muscle spasms for up to 14 days after the procedure. Your doctor may prescribe pain relief medication or physical therapy, depending on the severity of these side effects. Your doctor may also recommend applying ice packs to the insertion site at 20-minute intervals on the first day after the procedure.

Pain relief from the treatment usually occurs within 10 to 21 days. You will be given a follow-up appointment to evaluate the treatment progress and address any issues.

What Are the Risks & Side Effects of Radiofrequency Ablation?

Radiofrequency ablation is a relatively safe procedure with a minimal risk of complications. However, complications may include localized numbness, allergic reaction to medications used during the treatment, infection, and bleeding at the insertion site. Lack of pain relief, worsening of the original pain, and permanent nerve damage may also occur.

Side effects of radiofrequency ablation include temporal numbness, a burning sensation, or pain at the treatment site. These sensations may last a week or two after the procedure, but are usually alleviated by ice packs. If the pain persists, talk to your physician.

How Effective is Radiofrequency Ablation at Relieving Chronic Pain?

Statistically, radiofrequency ablation is effective in about 70% to 80% of patients. The specific degree of success depends on the location and cause of the pain. Pain relief from radiofrequency ablation can last anywhere between nine months and two years. The pain may come back due to the regrowth of the treated nerve, but that typically takes two or more years to happen. When this occurs, the procedure can be done again.

Is Radiofrequency Ablation Right for Me?

Radiofrequency ablation is a procedure that helps relieve chronic pain with a fast healing time and a low risk of complication. The physicians at Arkansas Surgical Hospital have performed this treatment many times, providing safe and satisfactory relief to chronic pain.

If you are suffering from chronic pain and have found no relief from pain medication and physical therapy, it may be time to try radiofrequency ablation. The surgeons at Arkansas Surgical Hospital can thoroughly evaluate your pain level and its location to determine if radiofrequency ablation is right for you. Request an appointment online or call (501) 748-8000 to schedule a consultation.

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