Radiofrequency Ablation: What to Expect

By the GSMC pain management team

If arthritis in the small joints of your spine keeps flaring up, and injections have helped for a while but the pain keeps coming back, our team may talk with you about radiofrequency ablation (RFA). This guide explains what RFA is, how we check whether it may help you, what happens on the day, and what recovery looks like.

This is Day 5 of our spine and sciatica series. Day 4 covered epidural steroid injection: what to expect.

What is radiofrequency ablation?

Radiofrequency ablation uses gentle heat from a thin needle-like probe to calm the small nerves that carry pain signals from a joint. In the back and neck, it usually targets the medial branch nerves that serve the facet joints. The nerves can grow back over time, so relief is not permanent, but it often lasts longer than a steroid injection.

Who may be a candidate?

• Back or neck pain that has lasted at least 3 months and comes mainly from the facet joints.
• Pain that has not improved enough with physical therapy, activity changes and medicines.
• Good short-term relief from test injections called medial branch blocks.
• RFA is also used for some types of knee, hip and SI joint pain, and for some headaches that start in the neck.

Step 1: Test blocks

Before RFA, we usually do one or two medial branch blocks. A small amount of numbing medicine is placed near the nerves using X-ray guidance. If your usual pain drops a lot for several hours, those nerves are likely part of the problem, and RFA may help. Keep a pain diary on the day of each block to share with us.

Step 2: The day of the procedure

• Most visits take about 30 to 90 minutes, and you go home the same day.
• You lie on your stomach for low back RFA. The skin is numbed, and some people receive light sedation if it is available and appropriate.
• Using X-ray guidance, we place each probe next to the target nerve. A short test checks the position before any heat is used.
• The area is numbed again, and each nerve is treated for about 90 seconds.

Plan to have someone drive you home.

After RFA and recovery

• Soreness, a burning feeling or a sunburn-like skin sensation near the site is common for 1 to 2 weeks.
• Ice for 15 to 20 minutes at a time may ease soreness. Rest the day of the procedure.
• Many people return to light activity and work within a day or two. Ask us if your job involves heavy lifting.
• It often takes 2 to 4 weeks to feel the full effect. Keep up with your home exercise program.

How long does relief last?

It varies from person to person. Many people have relief for about 6 to 12 months, and some longer. Others have less benefit. If pain returns as the nerves grow back, the procedure can often be repeated.

Risks

Every procedure has risks. Common ones include short-term soreness, a flare of pain and numbness or tingling in the skin near the treated area. Less common risks include infection, bleeding and nerve irritation. Our team will go over your specific risks before the procedure.

Call us right away if you have fever or chills, redness or drainage at the site, new weakness, or pain that is much worse than before. Call 911 for trouble breathing, chest pain, or loss of bladder or bowel control.

Radiofrequency ablation at GSMC

Our team evaluates back, neck and joint pain at all 7 GSMC offices in Ocean and Monmouth County: Whiting, Toms River, Brick, Barnegat, Manahawkin, Freehold and West Long Branch. Call to confirm which office offers RFA for your visit. Many plans, including Medicare, cover medial branch blocks and RFA when criteria are met, and we verify your benefits before scheduling. Tomorrow in our series: spinal cord stimulation after failed back surgery.

Call 732-202-3000 or request a consultation.

Frequently Asked Questions

Is radiofrequency ablation painful?

The skin and deeper tissue are numbed first. Many people feel pressure, and some feel brief discomfort. Soreness for a week or two afterward is common.

How long does radiofrequency ablation last?

It varies. Many people have relief for about 6 to 12 months, and some longer. If pain returns, RFA can often be repeated.

What is the difference between RFA and a facet injection?

A facet injection or medial branch block uses medicine for short-term relief and helps confirm the pain source. RFA uses heat to calm the nerves, so relief usually lasts longer.

Can I drive after radiofrequency ablation?

Plan to have someone drive you home on the day of the procedure.

Does Medicare cover radiofrequency ablation?

Medicare and many other plans cover RFA when criteria are met, such as good relief from test blocks. We verify your benefits before scheduling.

Medical disclaimer: This article is for general education only and is not medical advice. Please talk with your own doctor about your symptoms and treatment. Individual results vary.