Radiofrequency ablation is a procedure using a specialized machine to interrupt nerve conduction on a semi-permanent basis. The nerves are usually blocked for a period as short as 3 months, or as long as 18 months.
You must have responded well to the medial branch blocks to be a candidate for radiofrequency ablation.
The procedure is done under fluoroscopy (live X-ray guidance). Depending upon the area treated, the procedure can take from 20 to 30 minutes. Nerves cannot be seen on X-ray, therefore the needles are positioned using bony landmarks. After the skin is cleaned with an antiseptic solution, a local anesthetic is injected to numb the skin. A special needle is positioned using X-ray, and electrical stimulation is done. This stimulation may produce a buzzing or tingling sensation. You may also feel your muscles jump. The tissues surrounding the needle tip are then heated when the current is passed using a special radiofrequency machine. The procedure disrupts nerve conduction and may in turn reduce pain. Approximately 80% of patients experience a decrease in pain, or complete pain relief after this procedure.
Will the procedure hurt?
The skin and deeper tissues are numbed prior to placing the needles. You will also be sedated for the procedure. You will be awake, but usually comfortable during the procedure. During the procedure we will need to interact with you.
Unless otherwise instructed, you should not eat or drink anything 8 hours before the procedure. You should stop taking any blood thinning medications as previously discussed. You may take your normal medications with a sip of water. You will need a driver, and will not be able to drive the rest of the day.
Risks and side effects
Generally speaking, the procedure is safe. However, with any procedure there are risks and potential side effects. The risks and complications are dependent upon the sites that are lesioned. There is always a risk of infection. This is why sterile conditions are used. The nerves to be lesioned may be near blood vessels or other nerves which can be potentially damaged. However, these complications are not common.
Go home and limit activities for a day or so. Initially there may be muscle soreness. Ice packs will usually control this discomfort. After the first week is over, your pain may be gone or markedly reduced. If successful, the effects of the procedure can last from 9-12 months.