If you suffer from chronic low back pain or neck pain and do not find relief from other pain management treatments or interventional medicine, radiofrequency lesioning (RFL) may be a good option.
What is Radiofrequency Lesioning & Ablation?
Radiofrequency lesioning (ablation) is a pain management treatment that disrupts nerve signals on a long-term basis. It is a minimally invasive procedure that uses radiofrequency energy – electrical impulses – to destroy damaged nerves or tissues that send pain signals to the brain. By disrupting the communication between the nerve and the brain, the patient’s pain is reduced. This outpatient procedure can provide lasting relief in patients with chronic pain.
Radiofrequency lesioning is typically recommended for patients who have not found relief from other interventional pain treatments such as physical therapy or nerve blocks.
How is It Performed?
Before radiofrequency lesioning is performed, physicians run a diagnostic nerve block to determine if the procedure will be successful.
This procedure can take anywhere between 30-60 minutes, including a period of rest after the injection. Patients may undergo local anesthetics or even mild sedation, depending on the location of their treatment to numb the area before the procedure begins. Because it is an outpatient procedure, the patient remains awake and provides feedback to the administering physician.
RFL is performed under fluoroscopic guidance (X-Ray) to assist in accurate needle placement to the medial nerves that are being treated. With the use of a radiofrequency needle and microelectrode, the site and surrounding tissues are stimulated by a small radiofrequency current. The X-Ray guidance allows the doctor to watch in real-time to make sure the needle is being injected into the correct location. Occasionally, the doctor may use contract to confirm the correct needle placement. Patients have reported slight discomfort, but usually feel more pressure than pain.
The electrical impulse is passed through the needle and creates a small burn – called a lesion. This heats the nerve to approximately 80 degrees Celsius, which then destroys the nerve, blocking the pain signals. Multiple nerves can be burned at the same time.
If successful, the procedure can be done multiple times.
What Conditions Can be Treated with Radiofrequency Lesioning & Ablation?
Radiofrequency lesioning can be used to treat chronic pain conditions such as:
- Facet joint nerves
- Sacroiliac joint nerves
- Peripheral nerves
- Spinal arthritis & stenosis
- Sprains & strains
- Chronic back pain
An advantage of RFL is that it works and blocks the pain signals to provide long-term relief. Patients who have success with radiofrequency lesioning can expect relief for 6 to 9 months.
Potential Risks Involved
There is very little risk involved in having this procedure performed. It is very safe, however there have been reported complications that include nerve pain, neuroma, infection, and allergic reaction to the medication used during the procedure. Temporary side effects can include numbness in your legs or swelling and/or bruising at the incision site.
Less than 30% of patients do not experience any relief from their pain.