Radiofrequency ablation, also called radiofrequency neurotomy, is a minimally invasive procedure that uses electromagnetic waves and heat to reduce back and neck pain. This procedure is usually recommended for patients who have not experienced pain relief from conservative and interventional treatments such as pain medication, steroid injections, and some nerve blocks. During the procedure, a small generator creates radiofrequency energy and delivers it to damaged nerves in the spine. By selectively destroying these nerves, pain is either reduced or eliminated for up to 12 months depending on the patient’s condition and symptoms.
To begin the radiofrequency lesioning process, patients are asked to lie down on their stomach with the skin of the affected area exposed (i.e. the neck, mid-back, or low back). This area will be thoroughly sanitized before the physician numbs it with a local anesthetic. Using x-ray guidance, a radiofrequency needle is directed through the skin and onto damaged medial branch nerves. A small generator creates electrical stimulation, which is then sent through the tip of the radiofrequency needle and onto the damaged nerves. During this process, a patient’s pain may be recreated, followed by a slight muscle spasm. When this occurs, the physician knows they’ve identified the nerves causing pain. These medial branch nerves are then numbed and heated [locally destroyed] for approximately 1 minute. This process may be repeated for 1-5 additional nerves. The entire procedure takes about 30-90 minutes.
Patients may return home about 30-60 minutes after the procedure. A friend or caregiver will need to transport the patient home because driving is not permitted for at least eight or more hours. The treatment area will be sore for several days, and muscle spasms may occur while the medial branch nerves are destroyed from the radiofrequency treatment. Patients may be given pain medication during this time to alleviate muscle spasms and soreness. An ice pack applied to the treatment area for 10 minutes several times a day for 3-4 days may also provide sufficient pain relief. Patients may not experience complete pain relief from the procedure for at least 2-3 weeks. This is usually how long it takes for the pain fibers to become eradicated. Redness, swelling, signs of infection, and increased pain should be reported to the physicians at Orthopedic and Wellness immediately.