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Radiofrequency Ablations

Radiofrequency ablation, also called rhizotomy, is a nonsurgical, minimally invasive procedure that uses heat to reduce or stop the transmission of pain. Radiofrequency waves ablate, or “burn,” the nerve that is causing the pain, essentially eliminating the transmission of pain signals to the brain.

This procedure is most commonly used to treat chronic pain and conditions such as arthritis of the spine (spondylosis) and sacroiliitis. It is also used to treat neck, back, knee, pelvic and peripheral nerve pain. The benefits of radiofrequency ablation include: avoiding surgery, immediate pain relief, little to no recovery time, decreased need for pain medication, improved function, and a quicker return to work and other activities.

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The patient lies on an x-ray table. Local anesthetic is used to numb the treatment area. The patient experiences minimal discomfort throughout the procedure. The patient remains awake and aware during the procedure to provide feedback to the physician. A light sedative can be used during the procedure.

The technique for nerve ablation is similar to that used for diagnostic blocks. With the aid of a fluoroscope, the doctor directs a needle into the area responsible for the pain. Fluoroscopy allows the doctor to watch the needle in real-time on the fluoroscope monitor to make sure that the needle goes to the desired location. 

Once the needle is in place, the patient receives an anesthetic medication through the needle. Then a radiofrequency current is passed through the needle to create a small and precise burn, called a lesion, about the size of a cotton swab tip. The current destroys the portion of the nerve that transmits pain and disrupts the pain-producing signal. The burn takes approximately 80 seconds for each site, and multiple nerves can be burned at the same time.

Radiofrequency nerve ablation is a relatively safe procedure with minimal risk of complications. The complications reported in the literature include: temporary increase in nerve pain, neuritis, neuroma, localized numbness, infection, allergic reaction to medications used during the procedure, and/or lack of pain relief (in less than 30% of patients).

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