Radiofrequency ablation (or RFA) is a procedure that can ease chronic pain for some people. The procedure uses radio waves that produce electrical currents. These currents heat and kill a small, targeted area of nerve tissue, preventing pain signals from going to your brain. The procedure only affects the targeted area and doesn’t affect any healthy nerves nearby.
You may also hear RFA called a rhizotomy.
Which Conditions Are Treated With Radiofrequency Ablation?
RFA can be used to help patients with different types of chronic (long-lasting) pain, including:
- Back pain, like from spondylosis
- Postherpetic neuralgia, or PHN (nerve pain after having shingles)
- Pain after an amputation
- Post-inguinal herniorrhaphy pain (chronic pain after hernia surgery)
- Arthritic pain in the large joints, like your knees, hips, or shoulders
- Cancer pain
- Facial pain caused by trigeminal neuralgia
Sometimes the procedure has a name associated to the type of pain that it treats, such as:
- Lumbar radiofrequency ablation: Treats the facet joints (areas where bones are connected to the spine) in the lower back
- Cervical radiofrequency ablation: Treats the cervical (neck) facet joints to manage neck pain and headaches
You might hear about RFA being used for other types of treatments too. For example, RFA can be used to:
- Shrink tumors or growths in the body
- Help regulate your heartbeat
- Treat premature ejaculation
- Remove thyroid nodules
How Long Does Pain Relief From Radiofrequency Ablation Last?
How much pain relief someone gets from radiofrequency ablation varies, depending on the cause and location of the pain. More than 70% of patients treated with RFA have pain relief. It can last from six to 12 months and in some cases, relief can last for years. The destroyed nerve can grow back though, causing the pain to return. If your pain comes back, you might be able to have the procedure again.
Is Radiofrequency Ablation Safe?
RFA is a safe and effective way to treat some forms of pain. It’s also generally well-tolerated, with very few associated complications. As with all medical procedures though, there are some risks. They include:
- Pain where the needle was inserted
- Numbness where the needle was inserted
- Nerve damage
- Original pain could get worse instead of better
- Infection at the site
- Bleeding at the site
Your doctor can advise you if you have any particular risks.
What Are the Side Effects of Radiofrequency Ablation?
There are few radiofrequency ablation side effects. The main one is some discomfort, including swelling and bruising at the site of the treatment. You can put an ice pack on the sore area, 20 minutes on, 20 minutes off, to help relieve this. Make sure you don’t put ice directly on your skin, though, to prevent injuring your skin. Soreness or bruising generally goes away after a few days.
If you had RFA in your spine, you might have some numbness in one leg. If this happens, don’t try to walk alone. Walk only with assistance so you don’t fall. This numbness should only last a few hours and is due to the local anesthesia given for the procedure. If the numbness continues, contact your doctor right away.
Other potential side effects after radiofrequency ablation:
- Bruising or swelling in the area
- Risk of bleeding or infection
- Possibility of nerve damage
- Allergic reactions to medications or materials used
Who Should Not Get Radiofrequency Ablation?
As with any medical procedure, not everyone can have RFA. For example, radiofrequency ablation might not be an option for you if you have:
- Active infections, especially in the skin around where the RFA is to be done
- Problems with blood clotting or you take blood thinners
- Increased pressure in your skull (intracranial pressure)
If you’re pregnant, your doctor may advise you to wait to have RFA until after the baby is born.
How Do I Prepare for Radiofrequency Ablation?
Your doctor’s office should explain how to prepare for an RFA, but these are the general instructions:
- Don’t eat for six hours before your appointment. Unless your doctor says otherwise, you can have clear liquids until 2 hours before the procedure.
- If you have diabetes and use insulin, consult your doctor about how to adjust the dosage the day of the procedure. Bring your diabetes medication with you so you can take it after.
- Continue to take all other medications with a small sip of water unless your doctor tells you otherwise. For example, if you take blood thinners, you’ll probably be told not to take them for a certain number of days before your appointment. Bring all your regular medications with you so you can take them after the procedure. If you take blood thinners, ask your doctor when you should start taking them again. Don’t stop taking any medications without first talking to your doctor.
- Arrange to have someone accompany you home after the procedure. You should not drive or operate machinery for at least 24 hours afterward.
What Happens During Radiofrequency Ablation?
You will meet with the doctor for an evaluation before the procedure. They will explain the RFA in detail and tell you about possible complications and side effects. This is the time to ask any questions you have.
You might get an intravenous (IV) line in a vein in your arm. This allows the nurse to give you a mild sedative to keep you relaxed during the procedure.
First, the doctor will use a local anesthetic to numb the area where the RFA needle will be inserted.
After the local anesthesia takes effect, the doctor inserts a small, hollow needle. X-rays or an ultrasound help your doctor guide the needle to the exact target area. Once your doctor has the needle in the target area, a tiny microelectrode is inserted through the needle.
The next step is a test to check if you feel a tingling sensation. This shows if the electrode is in the right spot. Even if you get a sedative, you will be awake during the process so your doctor can ask you if you feel that tingling sensation.
Once the needle and electrode placement are verified, a small radiofrequency current is sent through the electrode into the surrounding tissue, causing the tissue to heat up. You shouldn’t feel pain or discomfort during the heating portion of the procedure, although you might feel some tingling.
What Happens After Radiofrequency Ablation?
The RFA can take anywhere from 15 minutes to a couple of hours. Once done:
- You will stay for a while in a recovery room for observation, where a nurse will check your blood pressure and pulse, and monitor you.
- You might have a bandage over the injection site.
- You might be offered a drink.
- A nurse will review your discharge instructions with you.
- You will be discharged, but you must have someone with you to bring you home.
- You should check to see when you should follow up with your doctor.
Can I Resume My Normal Activities After Radiofrequency Ablation?
Your doctor’s instructions may be different, but the general instructions after an RFA are:
- Don’t drive or operate machinery for at least 24 hours after the procedure.
- You may eat and drink again.
- Don’t engage in any strenuous activity for the first 24 hours after the procedure.
- You might not be able to take a bath for one to two days after the procedure, but you may shower.
- You may remove any bandages in the evening before going to bed.
RFA Warning
If you feel severe pain at the injection site and notice swelling and redness or increased leg weakness, have someone take you to the nearest emergency room or call 911. Tell the emergency room staff that you just had RFA. A doctor must evaluate you for bleeding and injection complications.
Takeaways
Radiofrequency ablation, or RFA, is a procedure that can help relieve some types of chronic pain. It targets the nerves that cause pain and destroys them so they can’t send pain signals to the brain. RFA is safe and effective but it doesn’t work for everyone. If you get relief from RFA, the pain could return if the nerve regrows. There are very few complications related to RFA.
Radiofrequency Ablation FAQs
How long does it take to feel the effects of RFA?
If RFA works for you, you could feel pain relief right away or it can take up to 3 weeks.
How long do the effects of RFA last?
Some people can get full pain relief while others get only some relief. This can last for a few months to a few years. The pain can return if the nerve grows back.
What are the side effects of RFA?
RFA side effects are rare, but you could have some bruising or pain where the needle was inserted. Very rarely, people get worsening pain or an infection at the site. Bleeding could also occur, but it’s very uncommon.
How does RFA work?
RFA works through radio waves heating up the target nerve tissue and destroying it. The waves do not affect the healthy nerve tissue.
What is the recovery time for RFA?
You might be asked to restrict your activities for a day or so, depending on where the RFA was done, but otherwise, there is little recovery time. If you had sedation to make you relaxed, you may be drowsy for a while after the procedure.
