Overview
Radiofrequency ablation (RFA), also called radiofrequency neurotomy, uses heat generated by radio waves to interrupt small sensory nerves that carry pain signals from a joint. It is most commonly used for facet joint pain in the neck and low back.
RFA does not treat the underlying arthritis, and the nerves can regrow over time. Many patients who respond can repeat the procedure if pain returns.
Watch: how Radiofrequency Ablation works
Video: “Boston Scientific: How Radiofrequency Ablation (RFA) Works” from Chronic Pain Relief by Boston Scientific on YouTube. It loads from youtube-nocookie.com only when you press play. Shown for general education; GSMC did not produce it. Watch on YouTube
How it works
After numbing the skin, the physician uses X-ray guidance to place special needles next to the target nerves. A small electrode heats the nerve tissue to create a lesion that interrupts pain signals. Some systems use cooled radiofrequency.
Who it may be for
- Facet joint pain confirmed by diagnostic medial branch blocks
- Selected sacroiliac joint or knee pain
- Pain lasting several months despite conservative care
Your exam and imaging decide whether this treatment is appropriate for you.
What to expect
- Before: we review your medications (especially blood thinners), allergies and imaging. You may need a driver.
- During: you lie on a procedure table, the skin is cleaned and numbed, and the physician uses X-ray (fluoroscopy) or ultrasound guidance to place the needle.
- After: you are monitored briefly and usually go home the same day. Keep a pain diary so we can judge the response.
Recovery
Soreness at the treatment site can last one to two weeks. Relief often builds over several weeks. Your instructions may differ.
Risks and side effects
Every procedure has risks. Your physician will review them with you, including:
- Temporary soreness at the injection site
- Temporary increase in pain
- Bleeding or bruising
- Infection (uncommon)
- Allergic reaction (rare)
- Temporary rise in blood sugar if a steroid is used
- Temporary numbness or burning in the treated area
- Nerve injury (rare)
Insurance and cost
Many plans, including Medicare, may cover this treatment when criteria are met. We verify benefits before scheduling. See accepted insurance.
Frequently asked questions
How long does RFA last?
Relief commonly lasts several months to a year or more, but it varies. The procedure can be repeated if the nerves regrow.
Does RFA hurt?
Local anesthetic is used. Many patients also receive light sedation. You may feel soreness for a few days afterward.
Why do I need a test block first?
A positive diagnostic block suggests RFA is more likely to help.
This page is general patient education and does not replace advice from your own clinician. Individual results vary.