Radiofrequency Ablation

Radiofrequency ablation

What is radiofrequency ablation?

Radiofrequency ablation uses an electric current to heat up a small area of nerve tissue to stop it from sending pain signals. It can provide lasting relief for people with chronic pain, especially in the lower back, neck and arthritic joints.

Once a structure has been determined to be a pain generator, its nerve supply is targeted for interruption. A small insulated needle or RF cannula is positioned next to these nerves with fluoroscopic guidance (live video X-Ray). Your doctor knows where to place the RF cannula because he is an expert in anatomy. The shaft of this cannula except for the last 5 to 10 mm is covered with a protective insulation so that the electric current only passes into the surrounding tissues from the very tip of the cannula. When the cannula appears to be in good position, the doctor may perform a test and release a small amount of electric current through the needle tip at two different frequencies. This test helps to confirm that the cannula tip is in close proximity to the target nerve and that it is not near any other nerve. After a successful test confirms good cannula tip position, a local anesthetic is injected to numb the area. The RF generator is then used to heat the cannula tip for up to 90 seconds, and thus the target nerve is destroyed.

How is radiofrequency ablation done?

First, you’ll be given an intravenous medication to relax you. Then, you’ll lie on your stomach or back on an x-ray table.

The doctor will numb an area of your skin with a local anesthetic. Then, he or she will:

Insert a thin needle into the area where you feel pain; an x-ray can help your doctor pinpoint the exact area

Sensory and/or motor stimulation of the tiny medial branch nerves may then be performed to document correct placement.

Finally, a small radiofrequency current is sent through the electrode to heat and denature your nerve tissue

Usually, after the procedure you can go home the same day.

How effective is radiofrequency ablation?

Most patients have some pain relief after radiofrequency ablation, but the amount varies by cause of pain and location. The relief can last from 9 to 15 months. For some patients, the relief lasts years. Full benefit from the procedure may take 3-6 weeks.

What are the risks?

The risk of complication from radiofrequency ablation is very low. Serious complications, including infection and bleeding at the incision site, are uncommon.

Temporary side effects can include:

Weakness or numbness in your legs

Swelling and bruising at the incision site

What happens after the procedure?

You can continue your regular diet and medications immediately, but do not drive or do any rigorous activity for 24 hours after the procedure. Take it easy. You can return to your normal activities the next day.



Dr. Spiel’s unique clinical background has enabled him to view the practice of interventional pain through a broader perspective...

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A fellow of the American Academy of Orthopedic Surgery, Dr. Pflum earned his undergraduate degree at Georgetown University, Washington, DC ...

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