This minimally-invasive procedure, also called radiofrequency (RF) rhizotomy, reduces or eliminates the pain of damaged facet joints by disrupting the medial branch nerves that carry the pain signals. This procedure is performed with local anesthetic.

Radio Frequency Ablation

RFA can be used to help patients with chronic (long-lasting) low-back and neck pain and pain related to the degeneration of joints from arthritis.
The degree of pain relief varies, depending on the cause and location of the pain. Pain relief from RFA can last from six to 12 months and in some cases, relief can last for years. More than 70% of patients treated with RFA experience pain relief.
RFA has proven to be a safe and effective way to treat some forms of pain. It also is generally well-tolerated, with very few associated complications. Although it is effective, there is a slight risk of infection and bleeding at the insertion site. Your doctor can advise you about your particular risk before considering this procedure.
The main side effect of RFA is some discomfort, including swelling and bruising, at the site of the treatment, occasionall sensitive skin on the lesioned side but this will usually go away after a few days.
As with any medical procedure, RFA is not appropriate for everyone. For example, radio frequency ablation is not recommended in people who have active infections or bleeding problems, or pain goes all the way to toes. Our doctors will advise for or against RFA, should complications arise.

To prepare for radiofrequency ablation treatment, you should take a few precautions, including:

  • Do not eat or drink within six hours of your appointment. You may have clear liquids until two hours before the procedure unless you have IV sedation.
  • If you have diabetes and use insulin, you need to adjust to half of the dosage of insulin the day of the procedure. Your primary care doctor will help you with this adjustment. Bring your diabetes medication with you so you can take it after the procedure.
  • Continue to take all other medications with a small sip of water. Bring all medication with you so you can take it after the procedure. If pain is severe take half dosage of your normal pain medications. Please note: Do not discontinue any medication without first consulting with your primary or referring doctor.
  • You will need to bring someone with you to drive you home after the procedure. You should not drive or operate machinery for at least 24 hours after the procedure.
  • Come 30 minutes early to your procedure so that our staff may assess the procedure correctly.

You will meet with a doctor for an evaluation. If radiofrequency ablation is recommended, a doctor will explain the procedure in detail, including possible complications and side effects.

The doctor will also answer any questions you may have.

An intravenous (IV) line may be placed in a vein in your arm before the procedure and a local anesthetic and mild sedative may be used to reduce any discomfort during RFA. You may be awake during the process to aid in properly assessing the procedure. Ask your doctor about specifics beforehand.

After the local anesthesia (you will be awake but will not feel any pain) has been given, the doctor will insert a small needle into the general area where you are experiencing pain. Using fluoscopic guidance, your doctor will guide the needle to the exact target area. A microelectrode is then inserted through the needle to begin the stimulation process.

During the procedure, your doctor will ask if you are able to feel a tingling sensation. The object of the stimulation process is to help the doctor determine if the electrode is in the optimal area for treatment.

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. You should not feel discomfort during the heating portion of the procedure.

Following radiofrequency ablation

  • You will stay in a recovery room for observation, where a nurse will check your blood pressure and pulse.
  • A bandage will be placed over the injection site.
  • The nurse will give you a beverage and review your discharge instructions with you.
  • Someone must drive you home.

You will have a few restrictions immediately following radiofrequency ablation:

  • Do not drive or operate machinery for at least 24 hours after the procedure.
  • You may resume your normal diet.
  • Do not engage in any strenuous activity for the first 24 hours after the procedure.
  • Do not take a bath or shower for 24 hours after the procedure.
  • You may remove any bandages in the evening before going to bed.

You may experience the following effects after RFA:

  • Leg and skin numbness: If you have any leg numbness, walk only with assistance. This should only last a few hours and is due to the local anesthesia given during the procedure.
  • Mild back discomfort: This may occur when the local anesthetic wears off and usually lasts two or three days, if it occurs. Apply ice to the area the day of the procedure and moist heat the day after the procedure if the discomfort persists. You may also use your usual pain medications.

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