Radiofrequency Ablation

Those who suffer from chronic back and neck pain know how difficult daily tasks become. Couple that with not being able to find relief, and you’ve got yourself a lifestyle compromising situation. Radiofrequency ablation has proven helpful in many cases. It is used to successfully treat a wide range of medical conditions. The Nevada Advanced Pain Specialists serve the Reno, Sparks, and Carson City areas. They specialize in chronic back and neck pain conditions. They expertly use radiofrequency ablation to treat and manage pain symptoms.

What is Radiofrequency Ablation?

Radiofrequency ablation (RFA) uses radio waves to conduct a current that heats a small and precise area of nerve tissue. This heat destroys, or ablates, the specific nerve tissue. It stops the nerve from sending pain signals to the brain. Radiofrequency ablation provides pain relief for patients with chronic pain. It is especially effective for issues in the low back, neck, muscles, and arthritic joints.

This treatment method was first used to treat trigeminal neuralgia (a chronic facial pain disorder), but is now used to treat a wide range of chronic pain conditions. It offers many benefits, including helping a patient avoid surgery and providing immediate pain relief. Additionally, it improves function with minimal to no recovery time.

There are two main types of radiofrequency ablation, radiofrequency thermo-coagulation and pulsed radiofrequency. Radiofrequency thermo-coagulation involves the heating of the electrode to 122 to 176 degrees Fahrenheit, as it is kept in this range for several minutes. This process generates electro-thermal heat. It destroys the surrounding nerve fibers, preventing them from sending pain signals to the brain. This is also known as continuous radiofrequency ablation. 

Pulsed radiofrequency uses a lower level of heat administered in pulses. It shocks the nerve instead of destroying it. This adjusts how the nerve tissue functions. The goal is to reduce pain by altering the transmission of pain signals.

The type of ablation used depends on the patient’s chronic pain. It also depends on the desired outcome. Both produce well defined and small lesions, which allows for minimal or no damage to any surrounding structures. 

How Does Radiofrequency Ablation Work? 

Radiofrequency ablation is most often used after a medial branch block has proven helpful. A medial branch block is a minimally-invasive procedure where an anesthetic (and possibly a corticosteroid) is injected near the medial branch nerves. These tiny nerves are located near the facet joints of the spine and carry pain signals from these joints to the brain. The facet joints allow for a flexible connection between each vertebrae in the spine. Because of the web of bones, soft tissue structures and nerves in the spine, any damage done to the spine, or any condition that affects the spine, also has a great chance of affecting the nerves. 

The goal of the injection is to block the pain sensations from reaching the brain, thereby allowing for pain relief. If a medial branch block provides the patient with relief from their chronic pain, this means that the targeted nerves are the correct nerves, and utilizing radiofrequency ablation could help the patient to experience relief for a longer period of time. 

Radiofrequency ablation has also proven useful for treating the lateral branch nerve in the sacroiliac joints, which contributes to chronic low back pain, as well as the medial branch nerve in the facet joints. 

Can Radiofrequency Ablation Help Me Get Out of Pain?

Radiofrequency is an effective treatment option for patients who are suffering from chronic pain and have yet to find relief from other methods, such as pain medications and physical therapy. Not only does it help with a variety of chronic pain conditions, but can also help combat painful symptoms of other medical and health conditions. 

The most common pain conditions that radiofrequency ablation can successfully treat include: 

• Headaches
• Complex regional pain syndrome
• Chronic neck, back and knee pain
• Stroke-related pain
• Peripheral neuropathies
• Sympathetically mediated pain
• Disc denervations
• Facial pain caused by trigeminal neuralgia
• Arthritis of the spine (spondylosis)
• Occipital neuralgia

Radiofrequency ablation is also used to help reduce chronic pain caused by health conditions, including: 

• Cancer tumors (to kill cells) and liver, lung, kidney or bone cancers
• Obstructive sleep apnea
• Heart rhythm problems (cardiac arrhythmia or atrial fibrillation) 
• Barrett’s esophagus
• Varicose veins
• Dermatology

The overall goal of radiofrequency ablation is to help a patient experience complete or partial pain relief, improve function, reduce the need for pain medications, as well as delay or avoid surgery.

But isn’t damaging or destroying a nerve harmful to a person’s body and ability to function? Not in this case! The medial branch nerves control certain small muscles in the neck and mid/low back, but the loss of the targeted nerves does not lead to any significant loss of motor function. Additionally, the lateral branch nerves do not control any muscles, soft tissues or sensation in the arms or legs, so ablating certain lateral branch nerves in the sacroiliac joint in the low back pose a very minimal chance of having a negative impact on any arm or leg function. These nerves are targeted because they are believed to be the cause of many chronic pain symptoms, so ablating them successfully relieves pain without causing any additional nerve damage or loss of function/mobility to the neck, back or limbs. 

What Does Radiofrequency Ablation Involve?

Radiofrequency ablation, as previously stated, isn’t the first step in pain relief. A patient would generally partner with a pain management specialist who has performed a proper and thorough diagnosis, and recommended at-home and conservative methods for pain management. These could include pain medications, physical therapy, and alternative treatments (acupuncture, massage, chiropractic care, etc.). If the patient is still suffering from chronic pain, a nerve block is then performed to determine both that the targeted nerves are the affected nerves and that stopping the nerves from sending pain signals provided temporary or short-term pain relief. If all of these boxes have been checked, the healthcare provider will then recommend radiofrequency ablation with the goal to provide long-term pain relief. 

The procedure itself is performed in an outpatient setting, meaning that the patient is able to return home the same day. After the patient lies face down on their stomach, the provider will sterilize the area of the spine where the injection is to be performed. A topical anesthetic will then be applied to numb the skin before a thin needle is inserted into the target area, which is done using fluoroscopic guidance. The provider will then confirm the desired location by inserting a microelectrode through the hollow needle. If the patient feels a tingling sensation, that means that the intended area has been confirmed. 

Inject A Local Anesthetic

The provider will then inject a local anesthetic to numb the area around the targeted nerves before delivering the heat-generating electrical current. Corticosteroids might also be injected if there is present inflammation. The heat current destroys the affected nerve, thereby stopping pain sensations from reaching the brain. If needed, more than one nerve can be ablated during the procedure. 

The entire procedure itself could take anywhere from 30 minutes to an hour and a half, depending on the quantity of nerves treated. Patients are encouraged to rest for the remainder of the day. Some soreness at the injection site is to be expected, but over-the-counter pain medications should help, as well as ice packs. As it is not major surgery, there is very little recovery time and most patients can expect to enjoy their active lifestyle as quickly as a few days after the procedure. Most patients report pain relief for up to six months. 

Another helpful and often recommended recovery and rehabilitative tool is utilizing physical therapy efforts. This is because many patients have been de-conditioned during their months or years of chronic pain. Practicing a safe and effective physical therapy regimen allows these patients to increase their strength and tolerance for certain activities in a safe manner. 

What are the Benefits and Risks of Radiofrequency Ablation?

The main benefit of radiofrequency ablation is that it is a very safe and effective treatment option for providing reduced or complete chronic pain relief for the short or long term. In fact, one of out of five patients experienced complete pain relief, and more than half report mild to moderate pain relief. All patients were able to significantly reduce or completely halt their need for pain medications, and had no complications with therapy. 

The most widely enjoyed benefits of radiofrequency ablation include: 

• Chronic pain relief that hasn’t responded to other conservative methods
• No surgery
• Minimal, if any, recovery time
• Decreased need for pain medications
• Improved function
• Return to regular activities/lifestyle within a few days post-treatment 

It’s important to note that pulsed radiofrequency does not completely destroy the nerve, so they will regenerate over time. This means that the pain is expected to return, so additional ablation treatments will be needed to continue the period of pain relief. 

As with any medical procedure, there are risks. The good news with radiofrequency ablation is that the risks are minimal and any complications are rare. However, potential risks and complications can include: 

• Bleeding or infection at the injection site
• Temporary tenderness at the injection site
• Worsening of pain symptoms
• Permanent nerve damage

It’s important to discuss potential risks and benefits with your healthcare provider prior to beginning treatment. The amount of pain relief varies from person to person, but is also based on the cause, location and severity of the chronic pain symptoms. Overall, radiofrequency ablation is an extremely safe treatment method to help those who are suffering from chronic back and neck pain finally find relief. 

Who is a Candidate for Radiofrequency Ablation?

The best way to determine if you’re a candidate for radiofrequency ablation is to seek the help of a trained pain management specialist. Your provider will assess your particular location and severity of chronic pain, as well as review any previous treatments, current health status and health history, and review the risks and benefits with you. 

While radiofrequency ablation has proven helpful for treating a wide range of conditions that cause chronic pain and dysfunction, not everyone is a candidate.

Your healthcare provider might not recommend radiofrequency ablation if you have any of the below conditions: 

• Currently pregnant or think you might be pregnant
• Have uncontrolled diabetes
• Currently use steroids
• Weigh 250 pounds or more, or are considered obese
• Current blood clot condition
• Active cold or infection

Any or all of these aforementioned conditions can increase your chance of experiencing risks, or at the very least, less than ideal results. It is important to review all details of the radiofrequency ablation procedure, including the recovery requirements to determine if both you and your provider feel this is the best treatment option for you and your level of chronic pain. 

If you are suffering with chronic neck and back pain and have yet to find relief, the Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas are here to help. We understand just how difficult living with chronic pain can be, and are dedicated to helping our family of patients get back to their ideal lifestyle. Radiofrequency ablation is a safe and effective way to provide both short-term and long-term pain relief for a wide variety of pain conditions as well as health conditions that have painful side effects. In addition to proven immediate pain relief, radiofrequency ablation also helps patients to avoid and prolong their need for surgery, allows for improved function of the treated area of the body, and requires little to no recovery or down time. 

Please schedule an appointment today so that our team can answer all your questions, review your current health situation and medical history, and determine if you are an ideal candidate for radiofrequency ablation. We look forward to hearing from you and helping you finally find relief from your chronic pain symptoms!