Who Can Benefit From Radiofrequency Ablation
Radiofrequency ablation is a minimally invasive procedure we use to treat a wide range of chronic pain conditions. It harnesses the power of radiofrequency waves to heat and then remove malfunctioning nerves. This effectively turns off the flow of pain signals to your brain, giving you much-needed relief from your symptoms.
Why radiofrequency waves? Theyre powerful enough to target and eliminate your nerves but safe enough not to cause damage to your other tissues and cells. Radiofrequency waves are classified as non-ionizing radiation, which means they dont have enough energy to compromise the health of your cells. In fact, you can find radiofrequency waves in everyday items like your WiFi router and smartphone.
Some of the most common causes of chronic pain that radiofrequency ablation can treat include:
- Arthritis of the spine
We conduct a thorough review of your symptoms and health history to determine if your pain stems from a nerve problem before recommending radiofrequency ablation. You may not be a candidate if youre pregnant, have an infection, or have a bleeding problem.
What If Radiofrequency Ablation Doesn’t Work
If a radiofrequency ablation doesnt help your pain, there may be other options for pain management.
Radiofrequency ablation is a procedure that uses an electrical current on a nerve to try to reduce pain. Just like the name states, the procedure uses radio waves to produce an electrical current, which then ablates, or erodes, the nerve. Its minimally invasive and long-lasting, so its a very helpful option for people experiencing chronic pain.
With this procedure, the goal is that by targeting the nervewhich sends out pain signals to your brainthe amount of pain you are experiencing will decrease. It works by essentially turning off the pain signal from that nerve to your brain. However, radiofrequency ablation works differently for every person.
Heres what you need to know if radiofrequency ablation has not seemed to help your pain.
How Long Does Radiofrequency Ablation Take to Work?
One of the most important things you should know about radiofrequency ablation is that the pain relief effects from the procedure are not always immediate. For many people, pain relief will start to kick in around 10 days after having the procedure. However, for some people, it can take up to two or three weeks after the procedure for noticeable relief to begin. You may even experience a small amount of increased pain in the days immediately following the procedure, due to the nerves being irritated but that is a normal will decrease with time.
What Comes After Radiofrequency Ablation
Less Pain After Surgery
Patients treated with radiofrequency ablation are less likely to experience severe pain during their procedure than those with chemical Sympathectomy.
This is because RFA treatments only target the ganglion neurons causing pain signals to be sent along nerves in a specific area.
With chemical Sympathectomy, any neuron in the body is a potential target which means unnecessary nerve damage to surrounding tissue and organs.
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How The Alternatives Compare
In essence, ablation has an amazing success rate and arguably does more for your back and arthritic pain compared to these surgical alternatives, including the surgery itself. To explain, the success of ablation can range anywhere from 70%-90% depending on the situation, but even then, the procedure can be repeated if the results were not as expected.
There is no medication that will fix nerve damage or prevent them from sending pain signals to your brain, nor will any amount of physical therapy do the same thing. The solution is a procedure that corrects the of the pain and not just the pain itself.
Nerve Blocks And Radiofrequency Ablation
A nerve block is a procedure in which an injection of an anesthetic is delivered to a specific nerve to relieve pain. Your doctor may also use nerve blocks as a diagnostic tool to determine the source of your pain. Radiofrequency ablation of a nerve is sometimes used to provide longer lasting pain relief after a diagnostic nerve block.
- Procedure in which an injection of an anesthetic is delivered to a specific nerve to relieve pain.
- Your doctor may also use nerve blocks as a diagnostic tool to determine the source of your pain.
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Cervical Block / Radiofrequency Ablation
The spine is made up of 24 bones stacked into a column. These bones are the vertebrae. Between each vertebra is a cushionthe diskthat acts as a shock absorber between the bones. Every vertebra has two sets of bony knobs that meet between each vertebra. The point where they meet is called the facet joint.
The facet joints allow the spine to flex forward or extend backward. They also allow the spine to twist from side to side. A capsule of soft tissue protects these joint. A fluidsynovial fluidis made in this capsule to lubricate the joints so they move smoothly. A layer of slick white cartilage covers the joint, also helping it to glide smoothly when the body moves.
Over time, the cartilage can get damaged or wear thin. The joints can become enlarged. Spurs of bone may grow on or near the joint. This causes arthritis, pain and swelling in the joints.
Nerves that branch off from the spinal cord pass through the facet joints. They extend nerves into the body to control its activities and movement and receive sensation. These are called nerve roots. The nerves that serve the facet joints themselves are called the medial branches. They carry pain signals to the spinal cord and on to the brain. The pain is a warning sign that a joint is irritated.
The bones of the spine are grouped into three sections. The top part, which connects the skull to the torso is the cervical spine.
The 3 Steps Of Radiofrequency Ablation
Nearly 20% of American adults thats about 50 million people live with chronic pain. If youre one of them, you know how frustrating the search for relief can be. Fortunately, theres a way to disconnect the nerves in your body that are firing off pain signals.
Sound too good to be true? Here, our team at West Texas Pain Institute led by Dr. Raul Lopez gives you an inside look at how radiofrequency ablation shuts down your pain.
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Is Rfa Right For Me
If you suffer from chronic back pain that isnt effectively relieved by medications, physical therapy or injections, your pain specialist may recommend RFA. This procedure may also help alleviate increased pain with lifting or twisting movements. Here are a few other conditions that may be best treated with an RFA procedure:
- Left and/or right side lower back pain
- Back pain that extends through the buttock and thigh regions
Nerve Damage Is Permanent And Prevents Some Patients From Driving
For those patients who experience paralysis following treatment, the loss of sensation may prevent them from ever driving again. This can be especially difficult for young individuals with family responsibilities who already feel additional stress since they cannot drive during their recovery.
It’s extremely important to educate patients about nerve-burning side effects before the procedure begins so they are aware of possible risks associated with this form of therapy.
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Who Is A Candidate For Radiofrequency Ablation
Radiofrequency ablation may be right for you if have:
- Pain relief following a nerve block injection. This tells your provider that that particular nerve is the source of your pain and is an appropriate target for RFA.
- Chronic pain that does not respond to other treatment, such as pain medication and physical therapy.
You may not be a candidate for radiofrequency ablation if you:
What Are The Risk Factors For Developing Low Back Pain
Anyone can have back pain. Factors that can increase the risk for low back pain include:
Age: The first attack of low back pain typically occurs between the ages of 30 and 50, and back pain becomes more common with advancing age. Loss of bone strength from osteoporosis can lead to fractures, and at the same time, muscle elasticity and tone decrease. The intervertebral discs begin to lose fluid and flexibility with age, which decreases their ability to cushion the vertebrae. The risk of spinal stenosis also increases with age.
Fitness level: Back pain is more common among people who are not physically fit. Weak back and abdominal muscles may not properly support the spine. Weekend warriorspeople who go out and exercise a lot after being inactive all weekare more likely to suffer painful back injuries than people who make moderate physical activity a daily habit. Studies show that low-impact aerobic exercise can help maintain the integrity of intervertebral discs.
Weight gain: Being overweight, obese, or quickly gaining significant amounts of weight can put stress on the back and lead to low back pain.
Genetics: Some causes of back pain, such as ankylosing spondylitis , have a genetic component.
Smoking: It can restrict blood flow and oxygen to the discs, causing them to degenerate faster.
Backpack overload in children: A backpack overloaded with schoolbooks and supplies can strain the back and cause muscle fatigue.
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Can Nerve Regeneration Feel Like Nerve Damage
Yes. the symptoms of nerve regeneration, as the nerve growth cones fight through and around other tissue and send out weird signals that the brain has trouble interpreting, can feel very much like the symptoms of increasing nerve damage, at least for a while,
Can nerve damage cause burning pain in the spine?
Compression of nerve roots causes numbness and severe burning pain. Radiculopathy can also occur as a result of trauma or injury in the spine resulting in burning pain which can either be a shooting or sharp pain. The burning and stabbing pain resulting from an irritated nerve is called Neuralgia.
Post Injection What Next
The patient is kept in the hospital for approximately an hour following a nerve injection for follow-up tests.
This is done to determine whether or not the injection was successful and whether any complications occurred due to the procedure.
These may include
Arteries or veins may be punctured due to the sensitive location of the nerve roots, resulting in internal bleeding. This may cause tissue damage as well.
This can be avoided by using imaging to guide the injection and injecting contrast dye to ensure that the medicine is delivered to the correct location.
Because the procedure entails actively injecting the treatment close to the nerve roots, the needle may damage the nerve clusters. In some cases, this may go unnoticed because of the injection of numbing agents, which mask the nerve damage.
Guidance during the injection is also an effective method of reducing the risk of nerve injury.
- Allergic reactions to some medications used
Make sure to tell your doctor about any medication allergies you have and any current prescriptions to avoid this.
Before the procedure, you may need to stop taking certain medications, such as blood-thinning medications, because they will interfere with the blood clotting process.
Once a patient has been discharged, they are not permitted to engage in any strenuous activity resulting in further nerve damage.
Although the area is numb, the patient may experience some discomfort, mainly as the injection is administered.
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Dr Bhalani Shows How A Radio Frequency Nerve Ablation Can Help Relieve Pain
Do you have back pain? Is it due to arthritis of the lumbar facet joints? Dr. Maulik Bhalani shows how a radio frequency nerve ablation can help you Restore Function, Relive Life and is performed in the office based setting to relieve lumbar spine arthritis pain. This quick interventional pain procedure can provide back pain relief for month to years.
What Are The Risks
Radiofrequency nerve ablation is relatively safe procedure with minimal risk of complications. The complications reported in the literature include: temporary increase in nerve pain, neuritis, neuroma, localized numbness, infection, allergic reaction to medications used during the procedure, and/or lack of pain relief .
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Risks And Side Effects Of Rhizotomy
The risks associated with rhizotomy depend on the type of the procedure and which nerves its performed on.
- Glycerin/glycerol rhizotomy risks include bleeding, infection, nausea, vomiting, a small chance of sensory change and anesthesia complications.
- Radiofrequency rhizotomy has a higher likelihood of causing sensory change than the chemical method.
How Does Radiofrequency Ablation Work
Radiofrequency ablation uses heat produced from radio waves to target diseased tissue. When radiofrequency is applied to nerve tissue, it damages nerves, which prevents or stops the pain signal from reaching the brain and results in pain relief.
During a radiofrequency ablation procedure, a small hollow needle is inserted into the targeted nerve that is causing pain. An electrode is inserted into the top of the needle, which sends the radio waves through the needle to the targeted nerve. The heat causes a lesion that prevents the nerve from sending pain signals to your brain. Nearby healthy nerves are not damaged during the procedure.
Pain management within your spine
Radiofrequency ablation is often used to manage pain originating from joints and oftentimes related to pain from your spine, especially your neck and lower back .
Within your spine, nerves branch off from your spinal cord and travel to the facet joints and sacroiliac joints.
Facet joints are pairs of small joints between the vertebrae in your spine. These joints give your spine flexibility and allow movement of your back, such as twisting and bending. Two small nerves, called medial branch nerves, are connected to the facet joints and send a signal to your brain that there is pain coming from these joints.
Sacroiliac joints are found near the bottom of your spine, right above your tailbone. Lateral branch nerves that are connected to these joints send pain signals from the spine to your brain.
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Video: Lumbar Spine Anatomy
Learn how the lumbar spinal discs function and how lower back conditions can cause back pain and/or radiating pain.Watch Now
There are 5 pairs of lumbar spinal nerves that progressively increase in size from L1 to L5. These nerves exit the intervertebral foramina below the corresponding vertebra. For example, the L4 nerve exits beneath the L4 vertebra through the L4-L5 foramen. These nerves course down from the lower back and merge with other nerves to form the lumbar and lumbosacral plexuses , which innervate the lower limbs.
What Can I Expect During A Radiofrequency Ablation Procedure
A radiofrequency ablation procedure is minimally invasive and begins with a local anesthetic and possibly a mild sedative delivered via intravenous line. When the area for the procedure is numb and you are comfortable, your doctor will insert a hollow needle into the area of the affected nerves. Your doctor will use X-ray or fluoroscopic guidance to ensure accuracy and proper needle placement.
Once the needle is in position, your doctor inserts a microelectrode through the needle and into the area near the nerve. A weak electrical current runs through the microelectrode while it is put into place to double check for proper placement. You may feel a tingling sensation but it should not be painful.
Because proper placement is so crucial, stronger electrical current is run through the electrode directly into the nerve. This may produce twitching or throbbing in the surrounding muscles, but it is a necessary step to ensure proper placement.
After ensuring proper placement, treatment begins. Before applying continuous or pulsed electrical currents, your doctor may also inject a corticosteroid to reduce potential inflammation that occurs during or after the procedure. You should not feel any pain, as the numbing agents and mild sedatives you received in the beginning will still be effective.
In the following video, you can watch a procedure take place.
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How Is Radiofrequency Ablation Performed
Before the radiofrequency ablation procedure is performed, an anesthetic is usually intravenously administered to the patient to reduce discomfort. Next, a physician will use imaging technology to guide the placement of a special needle into the region of the spinal column where the affected nerves are located. After the correct position has been confirmed, a microelectrode that will provide the electrical current-induced heat is fed through the needle.
A mild electrical current is applied during the insertion of the microelectrode. This causes the patient to feel a tingling sensation and allows the physician to observe the patients motor and sensory responses to the stimulation. Nerves that are responsible for motor functions should not be directly targeted even if they are responsible for the pain as damage to such nerves may cause motor deficits.
After the optimal placement of the needle and electrode are confirmed, the physician will then initiate the continuous frequency or the pulsed frequency. Continuous radiofrequency ablation involves gradually increasing the frequency of the current until the electrode produces a temperature of 122-176°F . Once the appropriate temperature is reached, it is maintained for up to 90 seconds as this is the amount of time that is needed for the heat to disrupt nerve function.
Dorsal Root Ganglion Block
In this procedure, the dorsal root ganglion is injected with a local anesthetic and steroids, and the nerve root is effectively blocked.
The dorsal root ganglion is the area of a spinal nerve that connects to the spine and is located at the base of the spine. Its primary function is to transmit convey information from external or internal sites of the body such as actual or potential harm, temperature, or muscle length to the central nervous system.
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