Radiofrequency Ablation (RFA)
Radiofrequency ablation uses electrical current generated by radio waves to heat and destroy specific nerve fibers that transmit pain signals. Under fluoroscopic guidance, a needle electrode is precisely positioned near the target nerve, and controlled thermal energy creates a lesion that interrupts pain transmission.
What Is It & Who May Benefit?
Radiofrequency ablation uses electrical current generated by radio waves to heat and destroy specific nerve fibers that transmit pain signals. Under fluoroscopic guidance, a needle electrode is precisely positioned near the target nerve, and controlled thermal energy creates a lesion that interrupts pain transmission.
Symptoms
- Facet joint-mediated spinal pain (cervical, thoracic, lumbar)
- SI joint pain (lateral branch RFA)
- Knee osteoarthritis (genicular nerve RFA)
- Failed back surgery syndrome
- Occipital neuralgia
How It's Performed
Patient positioned prone or lateral under fluoroscopic guidance
Local anesthesia and conscious sedation administered
Target nerve identified using anatomical landmarks and fluoroscopy
A insulated cannula with active tip positioned at target
Sensory stimulation at 50 Hz confirms nerve proximity
Motor stimulation at 2 Hz confirms safe distance from motor nerves
Thermal lesion created at 80°C for 60-90 seconds (conventional RFA)
Pulsed RFA at 42°C may be used near sensitive structures
Multiple lesions created if needed for adequate coverage
Post-procedure observation for 1-2 hours
Risks & Complications
- Post-procedural pain flare (10-15%)
- Neuritis
- Temporary numbness or dysesthesia (<2%)
- Infection (<1%)
- Bleeding or hematoma
- Theoretical risk of damage to adjacent structures
- Nerve regeneration and pain recurrence (typically after 6-18 months)
Benefits
- Significant pain relief in 60-80% of appropriately selected patients
- Minimally invasive, outpatient procedure
- Can provide relief for 6-18 months
- Repeatable if pain recurs
- Reduces analgesic medication requirements
- Improves function and quality of life
Recovery
Related Conditions
Facet Joint Syndrome
Facet joint syndrome (zygapophyseal joint syndrome) is pain arising from the facet joints of the spine due to degenerative changes, injury, or inflammation. It is a common cause of chronic spinal pain and is diagnosed clinically and confirmed with diagnostic medial branch blocks.
Sacroiliac Joint Dysfunction
Sacroiliac (SI) joint dysfunction refers to pain originating from the sacroiliac joint complex, a common but often underdiagnosed cause of low back and buttock pain. The SI joint transmits forces between the spine and lower extremities and can become painful through inflammatory, degenerative, or traumatic mechanisms.
Knee Osteoarthritis
Knee osteoarthritis (OA) is the most common joint disorder worldwide and the leading cause of disability in older adults. It involves progressive loss of articular cartilage, subchondral bone remodeling, synovial inflammation, and osteophyte formation in the knee joint.
You May Also Want to Understand
Is This Procedure Right for You?
A thorough clinical evaluation is essential to determine whether radiofrequency ablation (rfa) is appropriate for your specific condition.
Dr. Shahnawaz F Shah