FAQ’s on Radiofrequency Ablation
What is a Radiofrequency Ablation?
Radiofrequency ablation is a technique used for patients who have had one or more affected nerves confirmed as a chronic source of pain, and who have had a certain percentage of pain relief provided (over 60%) when the afflicted nerves are blocked. Ablation is the careful, controlled destruction of the nerve ending through heat to permanently stop the transmission of pain signals from the nerve to the brain. Performed correctly, radiofrequency ablation is painless for the patient and is able to provide long-lasting relief.
What will a Radiofrequency Ablation treat?
There are a variety of pain relief applications available to patients who are eligible to receive a radiofrequency ablation treatment. The most commonly treated source of pain in patients is chronic facet arthritis, which accounts for nearly 20% of all lumbar pain in patients. According to a study (Efficacy of combined treatment with medial branch radiofrequency neurotomy and steroid block in lumbar facet joint arthropathy, 2012) into a combined radiofrequency ablation and medical branch block, patients were able to achieve substantial long-term relief. Patients suffering from chronic discogenic pain may also be able to obtain long term pain relief (A randomized controlled trial of radiofrequency denervation of the ramus communicans nerve for chronic discogenic low back pain, 2004).
Radiofrequency ablation has also been shown to be an effective means of treatment for the sacroiliac joint and the sub-occipital nerve. Patients suffering from hemicrania continua (a unique unilateral headache) are also potentially able to obtain relief with radiofrequency ablation to the sub-occipital nerve according to a case study (Radiofrequency ablation of the supra-orbital nerve in the treatment algorithm of hemicrania continua, 2012).
How is Radiofrequency Ablation performed?
Ablation is performed as an outpatient technique, with many physicians opting to use full intravenous sedation for patients to reduce the risk of procedural error. For patients who choose not to receive sedation, a strong painkiller will be given in addition to the application of local anesthetic to the injection site. Ablation is performed by inserting a specialty ablation needle until it is in very close proximity to the afflicted nerve. The ablation probe will be guided into place with fluoroscopic imaging to ensure accuracy.
After the probe has been positioned where the physician determines most effective, the end of the probe will be stimulated with very minor heat. If the patient experiences pain during this stimulation, the probe has been placed too close to the nerve root and must be re-positioned. Ablation seeks only to affect the nerve endings and not the body of the nerve root. This process will be repeated until a patient does not react to the stimulation, ensuring that the probe has been positioned correctly where it will not inadvertently damage a nerve root.
Following the trial stimulation phase, the ablation probes will be heated in a carefully controlled manner to destroy the pain-causing nerve endings to provide symptomatic relief to the patient. The duration of the procedure will vary on a patient-to-patient basis, as the number of nerve endings present in the target area can be different for each individual (Radiofrequency treatment has a beneficial role in reducing low back pain due to facet syndrome in octogenarians or older.,2013).
How well does Radiofrequency Ablation work?
While many of the typical therapeutic methods offered to patients deal with relief in terms of months, radiofrequency ablation offers patients multiple years of relief. The average duration of relief is between one and two years, with symptoms only returning as the afflicted nerve ends begin to re-grow. After nerve endings have began to grow back, ablation can be repeated as necessary to maintain relief.
What are the risks of Radiofrequency Ablation?
The risks of radiofrequency ablation are small, but may be severe. There is a small chance of infection, bleeding, or soreness at the site of injection. The largest risk is that a nerve may be accidentally damaged during stimulation despite the prior trial stimulations. There is also the chance that scar tissue may form around the nerve root.