Long-term pain requires innovative intervention like radiofrequency ablation (RFA) to get relief. This treatment is one of the newest options available for doctors to ease the severity of back or neck pain. As novel as this treatment is, it still has a record of safety with few severe side effects. For those with chronic pain that does not respond well to other treatments, RFA may help.
Finding out more about this procedure is a smart move if you are interested in seeking this as a way to ease your aching. Get answers for the most common questions about this procedure, so you can have an informed discussion with your doctor to see if RFA is a good option for you.
What Is Radiofrequency Ablation?
Pain occurs when nerves send a signal to the brain that something in the body hurts. Radiofrequency ablation is a procedure doctors use to block these signals, preventing your mind from registering pain.
A doctor uses radio waves to create an electric pulse. This pulse consists of lightspeed electromagnetic waves that travel directly to the nerve, generating heat and killing the nerve tissue. This damage prevents the nerve from sending pain signals. Over time, the nerve may regrow, requiring additional treatments, making this a temporary solution for pain, though it can bring months of relief.
Since RFA is a minimally invasive procedure that effectively kills the targeted tissue, doctors have found many uses outside of pain relief for the treatment. For example, some physicians have adapted RFA to killing cancerous tissues or treating heart rhythm problems.
Because you don’t need a long recovery process immediately after the procedure, RFA is an outpatient operation. You can go home the same day but follow your doctor’s instructions for post-operative care and when you can return to work.
Who Benefits From This Procedure?
Those who have experienced long-term pain in the neck or back may benefit from RFA. Because the procedure works best when a doctor knows which nerves to target, you may have a nerve block done first.
The nerve block involves injecting a pain reliever with cortisone into the nerves in the painful area. The cortisone helps to reduce any swelling that puts pressure on the nerves while the pain reliever helps to ease the soreness. Nerve blocks only last for a short time, but if the procedure successfully brought you pain relief, you will likely get longer-term benefits from RFA.
Those with chronic conditions such as arthritis in the back (spondylosis), pain from previous spine surgeries, whiplash or neurological conditions can get relief through RFA.
Are There People Who Should Not Get RFA?
Though mostly safe with few side effects, RFA is not a procedure for everyone. Only your doctor can determine if you can get RFA. Always tell your doctor about all the conditions you currently have in addition to your full medical history to get the most accurate assessment of whether you can have RFA.
Generally, some patients may not be able to have RFA. If you currently have bleeding or an infection, you may not be a qualified candidate for radiofrequency ablation. Should either condition only be temporary, you may need to wait before getting RFA. Talk to your doctor about your situation and the possibility of getting RFA when it clears.
What Are Its Benefits?
As a minimally invasive procedure, RFA does not require the same extensive in-hospital recovery of other back surgeries. Because the doctor does not need to make a large incision for this operation, most patients tolerate it well and experience few complications.
Another benefit of this procedure is that it gives patients with long-lasting back pain an alternative to opioids or other drugs that carry multiple side effects or have stopped working. Unlike ice packs that will numb the pain for a few minutes, RFA will numb the nerves for months.
How Should You Prepare for Radiofrequency Ablation?
If your doctor has prescribed RFA, you will need to follow the preparation instructions. Because you will not have sedation or general anesthesia, you do not have to fast the night before. You will, however, need to refrain from eating six hours before you go in for the procedure. Up until two hours before you go to the treatment facility, you may continue to consume clear liquids.
If you take aspirin or blood thinners, you may need to stop taking those two weeks before the procedure, but check with your doctor first. For daily medications, you may take those as you typically would the day you get RFA. If you have diabetes and are insulin-dependent, talk to your doctor about the proper dosage of insulin to take that day.
You must bring someone with you to drive you home after the procedure. Doctors will not permit you to operate machinery or drive for 24 hours after RFA. Make plans accordingly before you have RFA.
Do not wear jewelry or difficult to remove clothes to the clinic when you go for the procedure. You should wear comfortable clothing that you can easily remove to make changing into the hospital gown less cumbersome. Leaving your jewelry at home means you won’t have to take it off or worry about losing it during the procedure.
What Happens During the Procedure?
You will be fully awake for RFA. A nurse will put an IV line into your arm to administer medications to help keep you calm and comfortable. During the procedure, you will wear a hospital gown to allow your doctor to access your back. While lying on your front on an X-ray table, the doctor will ask for your help to identify the correct placement for the needle.
Once identified, the doctor will use the X-ray to direct the needle to the medial branch nerve targeted. The doctor will insert a microelectrode in the needle. The microelectrode produces the radiofrequency wave that will generate the required heat. The current sent only lasts 60 to 90 seconds, but during that time, the signal will heat the nerve and stop it from sending pain signals. You will not experience any pain or discomfort from this heating portion.
At the end of the procedure, a nurse will take you into a recovery area and take your vital signs. You also will get a bandage over the insertion site of the needles. If you feel thirsty, you can have a drink at this point while the nurse discusses discharge information and how to care for yourself in the days and weeks after the procedure.
RFA will take from 20 to 60 minutes, depending on how many nerves the doctor must work on. Fewer nerves will require less time for the procedure. The doctor must also take time to accurately locate the pain-causing nerves. If the correct nerve does not get the treatment, you will not experience relief.
How Successful Is the Operation?
Doctors and patients both appreciate the high success rate from RFA. Its minimal complications also make RFA a good choice for those patients who qualify for it as a pain relief option.
For 70% of people who undergo RFA, the procedure helps ease their pain. However, it could take three weeks or more to get the fullest level of pain relief.
Keep in mind that radiofrequency ablation does not permanently stop the pain. It only temporarily prevents you from feeling pain from the irritated nerves. However, this procedure does offer longer-term benefits compared to drugs or nerve blocks. Seen in that light, this procedure is often successful for many patients.
Does It Hurt?
Though you will be awake for the whole procedure, you should not experience discomfort or pain. You will receive a local anesthetic to numb the needle insertion site. Depending on how the doctor does the procedure, you might feel a slight tingling or buzzing when the electromagnetic impulse passes through the needle.
Following the procedure, you may feel a small amount of discomfort around the needle insertion site. If you have any achiness in the area, feel free to use an ice pack for no more than 20 minutes at a time on the site up to three or four times a day. Do not use a heating pad on the day of the procedure.
The rest of the day after going home, feel free to resume your usual medications and diet. Before going to bed, you may take off the bandage from the insertion site.
You may shower 24 hours later, but do not bathe for one or two days. You cannot operate machinery, exercise heavily or drive for 24 hours, but after that, you should be able to resume your normal activities.
What Is Recovery Like?
Recovery from radiofrequency ablation is short compared to other procedures. You can return to your regular activities the day after you have RFA. If you have persistent pain or discomfort after a few days, talk to your doctor.
Don’t worry if full relief does not happen once you have passed the discomfort from the injection site. You may need a few weeks before complete pain abatement occurs.
With pain relief, you will find activity and exercise easier. However, if you had limited your lifestyle before RFA due to the pain you felt, you may not have the fitness level to pe right into vigorous exercise. If you would like to get back into working out, start slowly and work your way back into your previous fitness level. You can build up strength over time, but rushing the process can lead to injuries and strained muscles.
What Are Possible Side Effects of Radiofrequency Ablation?
As with all medical procedures, there is a risk of side effects. Those who do experience these typically feel some leg numbness from the local anesthetic. Have someone help you get around if you have this type of temporary side effect. It should wear off in a few hours. Contact your doctor if you still have leg numbness the following day.
Minor discomfort at the injection site in your back may appear in the hours after the local pain reliever wears off and last for two to three days. Ice will ease this pain as will over-the-counter pain medications.
Pain that persists or reaches severe levels you cannot ease with ice or medicine could indicate a complication. If you notice continued bleeding, severe pain, leg numbness or signs of infection at the site, go to the emergency room. These extremely rare symptoms could be signs of serious complications. Let the ER staff know that you recently underwent RFA so the doctors know to look for infection or bleeding problems from the procedure.
How Long Do the Pain-Relieving Effects Last?
For many people, RFA brings months of lasting pain relief from chronic conditions. Every case is different, but most patients will have at least six to 12 months of relief. Some lucky patients will get years of relief. The amount of relief you experience depends on factors such as why you needed RFA and the location targeted.
Because the nerves will try to grow back from damage caused to them, this procedure does not offer a permanent solution. If the nerves damaged from RFA regrow, they will start to send pain signals to your brain, once more causing you the original pain you felt before getting RFA. It usually takes six to nine months before this happens, though.
The good news is that you can repeat the procedure in the future if you need it. Should your pain return, you can have another RFA procedure to relieve the pain.
At least one study has shown that repeat RFA treatments are just as successful as the first, with 91% feeling relief after their second procedure and 80% after the third. The patients in the study first underwent successful nerve blocks so their doctors knew precisely where to target the RFA. Even those who had three procedures reported no neurological damage. The average length of pain relief also did not diminish significantly. For those who had two RFA procedures, the average relief of pain lasted 10.2 months, and those who had three treatments had an average of 9.8 months of pain relief.
This study suggests that if you need additional RFA treatments in the future, you can get them with similar results as your first procedure.
Find Out More at Alliance Orthopedics
Pain does not need to dominate your life. If you have tried other options that may have worked for only a short while or failed completely, you might be a candidate for RFA. The only way to know for sure if you can get RFA is to discuss the matter with a doctor.
If you want to talk to a doctor about radiofrequency ablation, visit us at Alliance Orthopedics. Our professionals have experience helping people in pain to get better faster through a myriad of treatment options, including surgical and non-surgical. Don’t let your pain run your life. Contact us for an appointment to learn more about RFA and other treatment options for relief.