Radiofrequency Ablation for Pain Control
What is radiofrequency nerve ablation?
Radiofrequency nerve (RFN) ablation is a treatment that uses radiofrequency energy to heat and destroy nerves to reduce pain. When a nerve is heated in this way, it can no longer send pain signals. RFN ablation is commonly used to treat pain arising from facet joints. Tiny nerves, called medial branch nerves, supply facet joints and transmit pain. RFN ablation destroys these nerves, and lessens pain.
Will radiofrequency nerve ablation help me?
Before your doctor recommends RFN he/she will review how your pain changed in response to a series of medial branch blocks. Medial branch blocks are used to decide if you will get pain relief after RFN. If you have facet joint pain and a series of medial branch blocks result in relief of your pain symptoms, you have a greater chance of getting good pain relief after RFN.
What is the RFN procedure like?
Like facet joint injections or MBB, RFN is done with x-ray guidance. Intravenous medicines and local anesthetics are used to decrease the pain of the treatment and keep you as comfortable as we can. Specially-designed insulated needles are placed near or on the facet joint nerves. The RFN needle has a special tip that is not insulated and heats up. Once the needle is in place, the area is numbed and the needle is attached to the RFN machine. The heat produced at the needle tip destroys the nerve’s ability to transmit pain. It takes 80 – 90 seconds to heat and damage the nerve. Each nerve is heated at more than one site to increase the chances of getting a complete lesion. Some patients may find the treatment to be painful. You will be asked often during the treatment if you feel pain. The doctor can adjust the needle or give you more local anesthetic to lessen discomfort. If you feel pain, you must promptly tell your doctor. It can take 1 to 2 hours to complete the RFN. This depends on the site and number of nerves to be treated. When the treatment is over, the needle is removed and the sites are covered with sterile dressings.
What is the long-term effect?
After RF ablation, you may feel a slight increase in pain for 1-2 weeks, then your pain should be greatly reduced. The nerves may grow back over 6 – 18 months. Doing your physical therapy and staying active will increase the strength of the muscles and lessen your pain. If the nerves do grow back, you may not have the same level of pain that you now have. If your pain comes back, the treatment can be done again.
How do I prepare?
You should plan to spend 2 – 3 hours at the center. You will need someone to drive you home. Do not drive or make important personal or business decisons until the next day.
You cannot have this treatment if
- You have not had an MRI or CT scan of your spine.
- You have an active infection, such as a cold or sinus infection.
- You may be pregnant.
- Your current weight is over 250 pounds.
What should I do before the treatment?
If you are taking a blood thinner, please tell your doctor as your INR must be below 1.5.
- If you are taking 1 aspirin a day for your heart, you must get a letter from your doctor stating that you can stop it for one week. You will also need to stop NSAIDs (anti-inflammatory medicine) for 24 hours.
- You may take any of the medicines that you use for your low back pain except those above.
- Bring your pain medicine with you to take after the RFN, if needed.
What is recovery like?
- You may feel slightly increased pain for 1 – 2 weeks. This will slowly go away. Use your pain medicines, ice, and rest to reduce your pain. We suggest icing 20 minutes on and 20 minutes off. When you lie down, lie with the more painful side down.
- Your doctor may give you a drug called Neurontin® (gabapentin) to reduce pain.
- You should plan to take a few days off work so you can rest and take it easy.
- You should not shower for at least 48 hours. You should avoid soaking the site in a bathtub or pool for one week.
- You will come back to see your doctor in 4 weeks.
- Watch for signs of infection:
- Fever greater than 100.4° F by mouth for 2 readings taken 4 hours apart.
- Increased redness or swelling around the site.
- Any drainage from the site.
If you have any problems or new symptoms, please call us at (608) 265-1770, or (608) 263-9550.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 01/17/2013
Copyright © 07/02/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6074
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