Need Pain Relief? Consider Radiofrequency Ablation

Non-invasive, addresses neck and back pain
nerves in the shoulder and spine illustration

If you suffer from chronic neck and back pain, or chronic lower back pain, there is a minimally invasive option that you may want to discuss with your doctor called Radiofrequency ablation (RFA).  For some patients, RFA may reduce or eliminate pain for months at a time.

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The treatment uses an electrical current produced by radio waves to heat up a small area of nerve tissue, decreasing pain signals from that specific area, such as the neck or back.

“As we age, the joints in the neck and spine are more likely to develop arthritis, which can result in chronic pain,” says pain management specialist Teresa Dews, MD, FIPP, vice chair of Pain Management and medical director of the Cleveland Clinic Pain Management Center at Hillcrest Hospital. She says RFA can help provide patients long-term relief.

Comprehensive approach best addresses pain

With the use of RFA, Dr. Dews suggests a comprehensive approach. “There are other things people can and should do to manage and relieve chronic pain. These include increasing their activity level, modifying how they perform their activities of daily living, and achieving and maintaining a healthy weight with exercise and a balanced diet.”

For example, pain treatment could start with various exercises and water therapy. But if a person needs additional intervention to address pain, they can explore RFA treatments as well. The results of RFA vary by patient, lasting on average from three to six months, and in some cases up to a year.

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Psychological tools (such as relaxation and stress management techniques) and non-narcotic medications are also options for treating chronic pain, along with interventional procedures like nerve blocks, of which RFA is one type. According to Dr. Dews, “for most patients, the best solution utilizes a combination of all of these pain management tools.”

What it’s like to have RFA

The procedure is relatively simple and typically covered by insurance. While the procedure may vary by medical center, here is how it is performed by Dr. Dews at Cleveland Clinic.

First, the physician reviews the patient’s medical history and completes a physical exam. If she determines that the patient is a candidate for RFA, she then conducts a diagnostic nerve block, which stops nerve function for a short time, similar to how a dentist uses Novocain®. If the temporary nerve block works to relieve the pain, then RFA is a viable option for longer-term pain relief.

Prior to the RFA treatment, a patient must fast for six hours and may need to adjust other medications taken on a regular basis.

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This is what happens on the day of the procedure:

  • An IV line is placed in the patient’s arm, and he or she is transported to the procedure room. 
  • The patient lies on his or her stomach. The patient’s back area is sterilized, then RFA probes are marked by medical staff using X-ray technology.
  • Local anesthesia is administered to numb the area, and the probes are inserted.
  • Additional numbing medication is administered via the probes, followed by the actual radio waves.

The procedure takes about 30 to 40 minutes, followed by a 15-minute recovery period during which the patient’s blood pressure and pulse are monitored. Patients may then return home with the assistance of a responsible adult driver. They come back for a follow-up visit in eight to 12 weeks.

Most patients have some minor discomfort shortly after the RFA procedure but are able to resume normal activities within 24 hours.

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