What is radiofrequency ablation?
Radiofrequency ablation is a minimally invasive treatment modality that uses radio waves to generate an electrical current that in turn delivers a focused beam of heat to targeted nerve cells. This heat burns (or ablates) the nerves to the point that they are damaged and can no longer transmit pain signals from the site of injury or inflammation to the brain. This results in temporary pain relief without the need for major surgery or opioid medications. While radiofrequency ablation may seem like a new treatment, it has actually been around since the 1930s and has been used to treat a variety of painful conditions.
Types of Radiofrequency Ablation
Radiofrequency ablation can be used to treat a variety of painful conditions. There are two primary types of radiofrequency ablation: continuous radiofrequency ablation and pulsed radiofrequency ablation. While very similar, pulsed and continuous radiofrequency ablation procedures differ in the manner in which they deliver electrical currents to the nerve being treated. As the name suggests, continuous radiofrequency ablation utilizes a steady current to deliver temperatures up to 175 degrees for one and a half to two minutes, while pulsed radiofrequency ablation modulates the current to produce lower temperatures that are used for a longer period of time. Each type of radiofrequency ablation has their own advantages and disadvantages, and they can be used to treat a variety of conditions; generally speaking, a physician will choose between pulsed and continuous radiofrequency ablation after considering the location and number of nerves that need to be treated.
How is radiofrequency ablation performed?
Radiofrequency ablations are performed in the outpatient setting by pain management professionals and will generally see patients discharged from the office or ambulatory surgery center within a few hours of the procedure. Furthermore, the procedure generally requires nothing more than a mild anesthetic at the site of injury and a light sedative to keep patients calm. Once the site is numb and the patient is calm, the physician will use various imaging techniques, like x-ray or fluoroscopic guidance, to guide a specialized needle to the nerve that needs to be treated. After the needle is in place and the physician has confirmed it is not near vital motor nerves, a high-frequency electric current is generated, ablating the nerve being treated. Sometimes physicians will also inject corticosteroids as the final step of the procedure, helping to control inflammation in the surrounding tissues.
The three most common areas of the body to be treated with radiofrequency ablation are the cervical spine (neck), lumbar spine (lower back), and knee. However, the procedure can also be used to treat facial pain, headaches, and facet pain. Before undergoing radiofrequency ablation, your physician will likely perform two or more nerve blocks to the targeted nerves, to confirm that they will respond to the treatment. In other words, physicians do not want to ablate nerves that they are not positive are responsible for your pain, so they use nerve blocks to “test” whether or not a radiofrequency ablation will be effective. Once these preliminary nerve blocks have proven that preventing targeted nerves from relaying pain signals to the central nervous system can generate lasting pain relief, your physician will proceed with a radiofrequency ablation, which can generate lasting, long-term pain relief.
What are the benefits of radiofrequency ablation?
The biggest benefit of radiofrequency ablation is that it can provide significant pain relief for up to twelve months with one or two treatments. It is also performed in an outpatient setting, so recovery time is significantly less than surgery and you can expect to be home in a matter of hours versus days for some surgeries. It is a very safe procedure with minimal side effects and does not require serious narcotics during the procedure or recovery.