RADIOFREQUENCY ABLATION (RFA)
Radiofrequency ablation procedure uses specialised equipment to target joint pain and nerve pain. It is a minimally invasive procedure that can provide intermediate to long-term pain relief from various types of chronic pains.
Radiofrequency treatment involves a pain specialist carefully placing needles directly to nerves that are causing pain, and a heat is produced at the tip of the needle and to the nerves. This interrupts the nerves sending signals to the brain, which can provide long-lasting pain reduction (6 months to a few years).
There are two types of radiofrequency treatment:
- Radiofrequency neurotomy creates heat to the nerves of 90°C to break down nerves (radiofrequency denervation). This treatment can provide lasting relief from 6 months to 2 years. It is typically used to treat pain from facet joints or sacroiliac joint pain.
- Pulsed radiofrequency creates heat to the nerves but at a lower temperature of 42°C so as to not actually break them down. It is typically used for nerve pain and can provide long-lasting pain relief.
Radiofrequency neurotomy is a procedure used to alleviate spinal pain where treatment is focused on the facet joints or sacroiliac joints affected by arthritis, degeneration or following an injury like a car accident or surgery.
If you have had pain relief with a test block, you may be a candidate for radiofrequency neurotomy, which can provide long lasting pain relief.
Specialised equipment generates heat that is then focused onto specific nerves and temporarily interrupts their ability to transmit pain signals. This heat is delivered to the targeted nerves via needles inserted through the skin around your spine. The procedure is performed under light sedation.
Radiofrequency neurotomy is performed on any part of the spine that causes you pain. This includes:
- Lower back pain (lumbar facet joint pain)
- Middle back pain (thoracic facet joint pain)
- Neck pain (cervical facet joint pain)
- Sacroiliac joint pain (SI joint pain)
- Leg pain (lumbar sympathetic plexus)
- Abdominal pain (sympathetic ganglion)
- Pelvic pain (hypogastric plexus)
Radiofrequency neurotomy works better in some people for pain management than in others. This therapy can be repeated if needed.
Pulsed radiofrequency is unique in that it provides pain relief without causing significant damage to nerve tissue. The mechanism by which pulsed radiofrequency controls pain is unclear, but it may involve a temperature-independent pathway mediated by a rapidly changing electrical field.
Pulsed radiofrequency can be performed on any nerve that causes or generates your pain. These include:
- Facial pain (mandibular nerve, sphenopalantine ganglion, stellate ganglion, supraorbital nerve)
- Arm pain (spinal nerve roots or the dorsal root ganglion (DRG), stellate ganglion)
- Chest pain (intercostal nerves)
- Abdominal pain (splanchnic nerves, coeliac plexus)
- Hip pain (obturator and femoral nerves)
- Knee pain (genicular nerves)
- Leg pain (spinal nerve roots or the dorsal root ganglion (DRG), sympathetic ganglia)
- Neuromas (benign growth of nerve tissue)
- Occipital headache (greater and lesser occipital nerves)
- Shoulder pain (suprascapular nerve)
- Trigeminal neuralgia (mandibular nerve, sphenopalantine ganglion, supraorbital nerve)
- Pelvic pain (pudendal nerves, ganglion Impar nerves)
Pretty much any nerve can be pulsed if done by safe and experienced hands of a pain specialist.
We are pleased to offer this new type of radiofrequency treatment that can be performed for hip and knee osteoarthritis pain.
When we perform cooled radiofrequency on the knee, we call it genicular nerve ablation.
More information on recent research published on genicular nerve cooled radiofrequency here.
When we perform cooled radiofrequency on the hip, we call it articular branches of the obturator and femoral nerve ablation.
For more information on Coolief
DID YOU KNOW?
Radiofrequency was first performed in the 1950s but the techniques and equipment have come a long way. Usually the pain is reduced from 6 months to 2 years following a radiofrequency ablation procedure, although even if we completely wear away a nerve with radiofrequency, nerve tissue can sometimes regenerate. If the nerve tissue regenerates, the pain can sometimes return. This can usually and easily be managed by repeating the radiofrequency treatment.
- Dreyfuss P, Halbrook B, Pauza K, Joshi A, McLarty J, Bogduk N. Efficacy and validity of radiofrequency neurotomy for chronic lumbar zygapophysial joint pain. Spine (Phila Pa 1976). 2000;25:1270-7.
- McDonald GJ, Lord SM, Bogduk N. Long-term follow-up of patients treated with cervical radiofrequency neurotomy for chronic neck pain. Neurosurgery. 1999;45:61-7.
- Husted DS, Orton D, Schofferman J, Kine G. Effectiveness of repeated radiofrequency neurotomy for cervical facet joint pain. J Spinal Disord Tech. 2008;21:406-8.
- Byrd D, Mackey S. Pulsed Radiofrequency for Chronic Pain. Curr Pain Headache Rep. 2008; 12: 37–41.
- Simopoulos TT, Nagda J, Aner MM. Percutaneous radiofrequency lesioning of the suprascapular nerve for the management of chronic shoulder pain: a case series. J Pain Res. 2012; 5: 91–97.
- Van Boxem K, de Meij N, Kessels A, Van Kleef M, Van Zundert J. Pulsed Radiofrequency for Chronic Intractable Lumbosacral Radicular Pain: A Six-Month Cohort Study. Pain Med. 2015 Jan 8. doi: 10.1111/pme.12670. [Epub ahead of print]