In many ways, radiofrequency ablation is a very similar technique to many of the nerve blocks that are frequently performed (facet block, etc.) for the treatment of chronic back pain and chronic neck pain. However, instead of injecting a local anesthetic at the site of pain, a special probe is placed at the target site. Radiofrequency waves are used to heat and destroy the target tissue. This eliminates the painful impulses coming to the spine and thereby decreases pain for an extended period of time.
Although there are several painful conditions that may be treated by this method, the most common condition is low back pain or neck pain caused by disease of the facet joints.
Initially, a diagnostic nerve block is performed by an interventional anesthesiologist who specializes in pain management. In this case, local anesthetic is placed at the presumed site of pain. If the pain is gone after the procedure and then reappears when the local anesthetic wears off, it is presumed that this particular nerve is the site from which the pain originates. If that nerve is then destroyed, then it is likely that the pain can be relieved for an extended period of time.
After you have the initial diagnostic injection, the pain management specialist will determine if you are a candidate for radiofrequency ablation and schedule you for the procedure. If you are taking any medications, such as blood pressure medications or blood thinners, you will need to discuss this with the doctor to determine whether or not to continue with them prior to the procedure. You must have someone with you after the procedure to drive you home. An intravenous catheter is placed prior to the procedure. A small amount of sedation is given intravenously to decrease anxiety. Monitors will be placed to watch your blood pressure, heart rate and blood oxygen. The skin is numbed with a small amount of local anesthetic (lidocaine or bupivicaine). Once the numbing medication is given, there is little or no pain during the injection. The radiofrequency probe is placed in the area. Using a x-ray machine and a small amount of electrical current the exact location for the nerve is determined. The target nerve is then destroyed by passing the electrical current through the probe, which is near the nerve. After the procedure is completed, you will have a brief recovery and will then be discharged home with your driver.
After the local anesthetic wears off, there will be some mild discomfort at the site. The pain management specialist may prescribe a mild pain reliever. It may take several days to see results from the procedure. Although there are no guarantees, the pain relief may last several months to a year or longer. If the pain returns at a later date, the procedure can be repeated.