Radiofrequency Ablation for Pain
Tory McJunkin, MD, is a pain specialist with Banner Surgery Centers Pain Treatments Program. His office can be reached at (623) 878-PAIN (7246).
Question: I’ve been experiencing chronic neck and back pain for more than a year and have heard from friends that radiofrequency ablation might help. What exactly is it and how do I know if it’s right for me?
Answer: Chronic, severe pain can be debilitating. Radiofrequency Ablation (RFA) is a minimally invasive pain therapy that has proven successful in reducing and/or eliminating pain for many patients with back, neck, muscle and other pain syndromes including chronic headaches.
There are essentially two forms of RFA – one that destroys the nerves that trigger pain and one, known as Pulsed-RFA that stuns painful nerves rather than destroying them. In both cases, a probe is inserted through a needle to provide controlled delivery of localized heat along a painful nerve to interrupt pain signals and decrease the brain’s perception of pain.
RFA is an outpatient procedure performed under local anesthesia along with IV sedation as needed. After cleaning the skin and injecting a local anesthesia to numb the area, a needle is placed through the numb tissue. Using X-ray guidance to locate the correct spot, the physician introduces an electrode into the center of the needle and then initiates stimulation. After verifying that the needle is in correct position, a local anesthetic, and sometimes a steroid medication, is injected. The electrode is then heated to between 50 and 80 degrees Celsius where it remains for several minutes while the heat destroys the surrounding pain fibers, thereby reducing pain.
Pulsed-RFA is similar to the procedure described above; however, a lower level of heat is produced. And, rather than destroying the nerve tissue, it stuns the nerve. Pulsed-RFA typically produces less discomfort with patients feeling only a mild pulsating sensation.
The benefits of RFA vary from patient to patient with some reporting complete pain relief and others reporting mild to moderate relief. In a recent clinical study, the majority of respondents also reported a reduction in their need for pain medication.
RFA is widely considered to be an extremely safe, well-tolerated means of treating many causes of chronic pain. And, as RFA continues to improve with better efficacy and fewer risks, more and more patients are experiencing pain relief without hospitalization. Like all medical procedures, there are some risks and potential complications. Though rare, complications may include: bleeding, infection, worsening of pain symptoms, discomfort at the injection site and motor nerve damage.
While the pain relief results of RFA are not permanent, patients generally feel relief for an average of 11 months. There are many pain management treatments and procedures available. Talk to your doctor or a pain management specialist to determine which options might be best for you.