Radiofrequency Ablation: Minimally Invasive Chronic Pain Care

Pain and Movement|June 25, 2019

BY KYLEIGH ROESSNER RN-BSN

Chronic back pain is debilitating. Managing it is a daunting task.

Common frontline treatments — such as physical therapy and opioids — are effective for some of the millions of Americans seeking relief from chronic back pain. But because back muscles and spines are complicated, there is no one-size-fits-all answer for how to cope with back pain.

Maybe you've tried painkillers to relieve your back pain. Maybe you've undergone invasive surgery. Maybe those haven't been the answer you've been looking for.

Maybe radiofrequency ablation (RFA) can be your solution.

The procedure is designed to be an alternative for people whose pain hasn't improved with medication or therapy, or who aren't candidates for surgical treatment. The amount of pain relief varies from person to person, the Cleveland Clinic says, but it could last months or even years — meaning you can get back to living your best life.

What Is RFA?

RFA uses heat energy to prevent nerves in the base of the spine from sending pain signals to the brain. The heat destroys the nerve fibers, effectively turning off their ability to send pain signals. No nerves, no signals — no back pain.

Using imaging scans as a guide, your doctor will gently insert a probe into the nerve areas causing you pain. Once the probe is in place, it's connected to a radiofrequency generator, which creates a high-frequency current that generates enough targeted heat to relieve pain.

Because the procedure is minimally invasive, the risk of complication during or after the procedure is relatively low. The recovery time is also significantly reduced, which means you regain function sooner and make a quicker return to your everyday life.

Who Makes a Good Candidate?

According to the Mayo Clinic, ablation is best for people who are experiencing back, neck and sacroiliac/buttock pain. It might also be helpful for long-term joint pain, particularly in the knees and hips.

Before the procedure, a specialist will test the targeted nerves to ensure that they're the underlying cause of pain. Some facilities, such as those at the Center for Diagnostic Imaging, will use a local anesthetic with or without steroid injection. If a person experiences significant relief, it's a good indication that radiofrequency ablation will be an effective form of treatment.

The Mayo Clinic also indicates that a person might be a candidate for radiofrequency ablation if other, less invasive interventions, such a physical therapy, and medication, have been unsuccessful, or if surgery is not a viable option.

Anyone considering this procedure should begin by discussing the therapy with their doctor.

What Can You Expect from Treatment?

The procedure is typically done by a pain management doctor who's been specifically trained to perform the ablation.

This procedure can be done under local anesthesia or with light sedation, which you should discuss with your doctor. This will help keep you comfortable, though its lasting effects mean that you'll need a friend or family member to drive you home afterward.

While you lie on your stomach, your doctor will apply a local anesthetic and insert the probe to treat the nerve. You might experience some numbness or pain at the insertion site after the procedure is completed. As with any invasive procedure, there is some risk of infection, bleeding and nerve damage, but these side effects are rare.

A Minimally Invasive Option

RFA is one option for people who are trying to figure out how to cope with back pain and who need a less invasive approach than surgery or for whom other interventions have been ineffective.

If you're experiencing persistent back pain, your doctor can help you decide if RFA is a good option for you.