Radio Frequency Ablation

Most people have not heard the term ‘Radio Frequency Ablation.’ Someone who has suffered chronic pain almost certainly has. Radio frequency ablation (RFA) is a minimally invasive procedure that has become frequently used for the results it produces. While the name of the procedure sounds intimidating, it is an ideal option for patients who have not achieved relief from their pain through medication or physical therapy. An RFA is an injection that uses radio-frequency energy to disrupt specific nerves that send pain signals to the brain. Radio-frequency energy is a type of controlled heat that targets specific nerves to help patients manage their pain. Patients who suffer from long-term back or neck pain are usually ideal candidates for an RFA.

So is it an injection or is it essentially a laser? The answer is; a little bit of both. The goal is to create a lesion on the nerve tissues that will work as a signal block. The ‘pain sending nerve’ becomes damaged and is unable to send any chemical information to the brain for the body to think it’s in pain. The use of thermal heat is the most commonly applied route for an RFA. The physician inserts a needle in the spinal region, and then a mild electric current is sent through the needle. The patient should only feel a mild tingling, which ultimately identifies the nerves that need to be targeted. Once the physician has identified those nerves, they will numb them, and apply the radio frequency. The heat emitted damages the pesky nerves, and begins the relief process. Approximately 70% of patients experience relief from their chronic pain. The length of the relief does vary from patient to patient. Some patients experience relief for months at a time, where some can even go up to two years. Other types of Radio frequency ablation are Pulsed RFA’s and Water-Cooled RFA’s. Pulsed RFA’s follow a similar procedure to the thermal RFA, but use a higher voltage to “shock” the surrounding nerves instead of damaging it. A Water-Cooled RFA uses multiple electrode channels that are actively cooled down with a flow of water. This prevents the current from reaching a higher temperature (as that of a thermal RFA) but allows a larger lesion to be created on the surrounding nerves. RFA’s are a safe and effective way to treat pain, and have very few associated complications.  

In a society that is both combatting an opioid crisis, and desiring to move towards being less opioid dependent, RFA’s and opioid addiction counseling are a solid option to discuss with your physician. After the RFA, you may expect some discomfort, and shouldn’t perform any strenuous activity. While patients should take it easy for 1-2 days after their procedure, they should also let their pain levels guide their movements for the following days. While a patient may initially be intimidated by the name of the procedure, once deconstructed it becomes an ideal route for a patient with long term back or neck pain to explore.