The Radiofrequency Ablation Procedure: A 2022 Deep Dive
By learning more about the radiofrequency ablation procedure (RFA), patients can make better informed decisions about their treatment plans.
With thousands of patients undergoing the radiofrequency ablation procedure each year, it’s becoming increasingly important for people to be aware of what it is, what to expect during this procedure, and its associated benefits and risks.
What is the radiofrequency ablation procedure?
Radiofrequency ablation is a non-surgical medical procedure that uses a strong electric current to heat up a small area of nerve tissue in the body.
This ablation procedure is minimally-invasive in that it uses radio waves to ‘burn’ the end of the nerve and reduce or block pain signals to the area to provide patients with much-needed relief from chronic pain.
Radiofrequency ablation involves combining thermal and electrical energy to destroy some nerve endings and generate positive clinical outcomes.
Commonly, it is used in those with chronic lower back pain, neck pain, headaches, arthritis, or as part of a treatment for vascular issues.
What are the types of radiofrequency ablation?
There are multiple types of radiofrequency ablation procedures that are performed in most healthcare facilities that offer this type of treatment.
These ablation types include:
- Pulsed radiofrequency ablation
- Water-cooled radiofrequency ablation
- Cryoneurolysis
Is radiofrequency ablation painful?
Oftentimes, numbing treatment will be applied to the area prior to radiofrequency ablation so as to minimize your pain. Your doctor can and will provide strong painkillers through an intravenous route as well.
Although you should not experience a lot of pain during the treatment, you may feel a little discomfort as the needle is inserted into the area. It’s not uncommon for people to report a superficial burning sensation during the ablation.
If you are experiencing a lot of pain during the procedure, you should tell the medical staff immediately!
After the treatment, you may experience pain that is often likened to sunburn for around two weeks. You may be given the advice to apply ice or heat to the area to relieve any symptoms!
How do I prepare for the radiofrequency ablation procedure?
Patients who have not responded well to conservatory management and are not ideal for surgery may be offered radiofrequency ablation.
Prior to the ablation, you will see your healthcare practitioner for a consultation.
Here, they will review your medical history and check any previous scan reports to identify the best area for treatment.
For example, if there is a specific nerve that has occluded and is causing pain in a downstream area, the doctor will be able to see this from your previous imaging results.
Patients who are taking regular anti-inflammatory and anti-platelet medications may be asked to stop taking them several days before the procedure to minimize risks of bleeding or adverse effects.
You will be asked to arrive at the healthcare facility on a specific date and at an allocated time for the ablation and it is usually performed at an outpatient clinic.
What happens during the ablation procedure?
This treatment can usually be performed as a day case in the outpatient clinic at your chosen healthcare facility.
On the day of the procedure, you will be given intravenous pain medications by an anesthetist. You remain awake during the procedure but the area is numbed with a local anesthetic so you won’t feel any pain.
It’s important that you remain awake so you can provide feedback to the practitioner throughout the radiofrequency ablation procedure!
With the help of a fluoroscope (x-ray), the doctor will insert a thin and hollow needle into the skin. The fluoroscope is used to guide them in real-time and ensure that the needle gets to the correct area.
You may feel slight pressure or discomfort during the insertion of the needle, but you should not experience any pain. A contrast agent may be used to amplify the fluoroscopy images so the doctor can identify where the needle is moving more easily.
Once the needle is in place, you will receive some numbing medication. Radiofrequency currents are then applied through the hollow needle to form a tiny lesion in the nerve.
This current destroys the ending of the nerve where the pain signals are being received. It takes just under two minutes to produce each lesion so, depending on how many lesions are required, the whole procedure can take anywhere from 15 to 45 minutes.
What happens after receiving radiofrequency ablation?
Usually, you will be able to walk out of the treatment room immediately after the ablation is complete! However, your practitioner may wish to monitor you for a short period of time after the procedure to ensure you’re okay before you can head home.
You must not drive home yourself.
Instead, get a friend or relative to take you, or use public transport.
You may experience discomfort or slight pain for a couple of hours or days, but you will likely be able to return to work within the week.
The doctor will give you a prescription for pain-relieving medications and will schedule a follow-up consultation several weeks post-procedure to check in with you. They will be interested to see how you’re getting on and whether the pain has subsided.
In your follow-up, you can also discuss whether you’d like to continue your current medications or switch to alternatives.
If the procedure was unsuccessful, it may need to be repeated. However, the ablation procedure is successful for 70-80% of patients.
What are the benefits of radiofrequency ablation?
Radiofrequency ablation is a great way to provide immediate pain relief with little to no recovery time!
It is an alternative to surgical treatments and may reduce the need for pain-relieving medications. Patients are, therefore, able to return to their everyday living more quickly and easily.
Are there any health risks or side effects associated with the procedure?
The risks of radiofrequency ablation are relatively low due to it being a non-surgical treatment option.
However, there are some temporary side effects and there is the potential for some long-term health risks.
Temporary side effects include numbness or weakness in the affected area and potential swelling and bruising at the incision site. Long-term risks include nerve damage and skin burn.
References
https://pubmed.ncbi.nlm.nih.gov/29494009/
https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-021-04102-1
https://pubmed.ncbi.nlm.nih.gov/30830462/
https://pubmed.ncbi.nlm.nih.gov/28339430/