Radiofrequency ablation is a minimally invasive procedure that uses gentle heat to interrupt the small nerves carrying pain signals from arthritic or irritated joints in the spine. For people whose back or neck pain improved with a diagnostic nerve block, RFA may offer longer-lasting relief than an injection alone.
Small nerves called medial branch nerves carry pain signals from the facet joints of your spine to your brain. The sacroiliac joints have similar nerves. When these joints are worn or inflamed, those nerves keep sending pain signals.
During radiofrequency ablation, sometimes called radiofrequency neurotomy or rhizotomy, your provider guides a thin needle next to the targeted nerve. A radiofrequency current heats the tip of the needle and creates a small lesion on the nerve that disrupts its ability to send pain signals.
RFA doesn’t fix the underlying joint, and nerves can gradually regrow. That’s why relief isn’t permanent, but for many people it lasts considerably longer than a steroid injection.
Your provider may recommend a facet joint injection for:
causing chronic lower back or neck paincausing chronic lower back or neck pain
Learn about Facet Joint Injection
that stays in the back rather than traveling down the leg
Learn about Low Back Pain
that stays in the back rather than traveling down the leg
Learn about Neck Pain
in selected patients
Learn about Sacroiliac Joint Injection
Facet pain usually doesn’t travel below the knee or into the hand. Pain that shoots down a limb is more often nerve-related, and an epidural steroid injection may be more appropriate. Learn about Epidural Steroid Injection
Lumbar radiofrequency ablation targets the nerves supplying the facet joints of the lower back. It’s the most common form of radiofrequency ablation for back pain, especially pain that worsens when standing, twisting or leaning backward.
Cervical radiofrequency ablation targets the facet joint nerves in the neck. Radiofrequency ablation for neck pain may be considered for chronic neck stiffness, pain when turning your head or headaches at the base of the skull.
You may be a candidate for radiofrequency ablation if:
The diagnostic block is an important step. It helps confirm that the targeted nerves are actually responsible for your pain before ablation is performed. RFA may not be recommended if you have an infection, a bleeding disorder or certain implanted electrical devices.
You’ll usually have one or more diagnostic nerve blocks first. If those help, your provider schedules the RFA procedure and gives you instructions about medications and eating beforehand. Arrange for someone to drive you home.
You’ll lie face down. The skin is numbed, and your provider uses imaging guidance to place the needle next to each targeted nerve. A brief test confirms the placement, the nerve is numbed and the heat is applied. Several nerve levels are often treated in one session.
You’ll rest briefly before going home the same day. Soreness near the treatment area is common for several days.
Most people return to light activities within a day or two. Discomfort from the procedure can last a week or more, and it may take a few weeks to notice the full effect.
When RFA works, relief can last several months and sometimes longer. Because nerves can regenerate, pain may return, and the procedure can often be repeated if it helped the first time. Staying active with a physical therapy program may help you get the most from the pain-free window.
Common, temporary side effects include soreness, a burning or sunburn-like feeling over the area and short-term numbness. Less common risks include infection, bleeding and temporary nerve irritation. Your provider will review your specific risks and any precautions if you have a pacemaker or another implanted device.
Call our office if pain or burning over the treated area keeps increasing, if you notice blisters or skin changes, or if you develop a fever, redness, or new numbness or weakness.
Seek emergency care right away if you lose control of your bladder or bowels, have sudden weakness in an arm or leg, or have trouble breathing.
Many insurance plans cover radiofrequency ablation when criteria are met, which often include successful diagnostic blocks. Prior authorization is commonly required. Our team can help you navigate this.
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The area is numbed, and many practices offer light sedation. Most people feel pressure and some warmth. Soreness afterward is normal and usually improves over one to two weeks.
Results vary. Many people get several months of relief and some get more. If pain returns, the procedure can often be repeated.
A facet joint injection delivers medication to reduce inflammation and often wears off sooner. RFA disrupts the nerve that carries pain signals, which may provide longer relief.
The targeted nerves mainly carry pain signals from the joints. They don’t control major muscles in the arms or legs, so RFA isn’t expected to affect strength or movement.
If injections helped but the relief didn’t last, schedule an evaluation at our Rego Park office to see whether RFA is a good next step.
