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Radiofrequency Ablation to treat back and neck pain in Sacramento

Radiofrequency Ablation (RFA) treat low back pain, midback pain, and neck pain.

Facet arthropathy is arthritis of the small paired joints that are found on each level of our spine.  When conservative treatments such as physical therapy, medication, and lifestyle modifications fail to provide adequate relief from back and neck pain, interventional pain management techniques may offer effective solutions. These minimally invasive procedures can target the facet joints directly, delivering medication to alleviate pain and reduce inflammation at the source, or indirectly by targeting the nerves that transmit pain signals from the painful area. A commonly used injection therapy for facet arthropathy is radiofrequency ablaltion (RFA) of the medial branch nerves.  RFA uses specialized needles and radiofrequency energy to destroy small nerve fibers that transmit pain signals from arhtritic areas of the spine, thus "turning-off" the pain.  Prior to performing radiofrequency ablation, two rounds of diagnostic nerve blocks are performed on the nerves to isolate the facet joints as a source of pain. Radiofrequency ablation can be performed in the cervical, thoracic, or lumbar spine, depending on the location of the pain.

Radiofrequency ablation lumbar

What to Expect During Radiofrequency
Ablation

What are the risks of the procedure?As with most procedures, there is rare risk of bleeding, infection, nerve injury or allergic reaction to the medications used.  Some short-term side effects may occur.

  • If local anesthetic spreads to nearby nerves, you may have weakness or numbness that can last for several hours. If this happens you may have to stay in the Pain Management Center until this resolves.

  • You may have increased pain for a few days after the injection, including localized pain at the injection site.

  • People with diabetes may have short-term elevation of blood sugars.

The procedure cannot be performed if you have an active infection, flu, cold, fever, or very high blood pressure. For your safety, please make your doctor aware of any of these conditions.

 

Will the injection hurt a lot?Most people say the stinging/burning of the numbing medicine is the most uncomfortable part of the procedure, although every person's response to any procedure is individual.

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What happens during the actual procedure?After you sign a consent form and your blood pressure is checked,

  • the procedure will be done in the fluoroscopy (x-ray) room with you lying on your stomach.

  • The back or neck is then cleansed with an antiseptic solution and sterile drapes are placed.

  • The skin is anesthetized (numbed) with a local anesthetic. This is felt as a stinging or burning sensation.

  • Using x-ray guidance, specialized radiofrequency needles are then advanced to the appropriate locations.   Proper location of the needles over the nerves is confirmed with mild stimulation of the nerves, which sometimes causes the muscles of the back to twitch.  Once we have conformed the needles are in the appropriate location, local anesthetic (with or without steroid) is injected through the needles and the radiofrequency lesioning is performed.

  • Your skin will be cleansed and bandages will be applied. The bandages can be removed on the next morning. Your blood pressure will be checked, and you will be able to leave with your ride after the doctor authorizes your discharge.

How will I feel after the injection?Your back pain may be improved immediately after the injection from the local anesthetic. Some local tenderness may be experienced for a couple of days after the injection, rarely this pain will persist for up to 2 weeks. Using an ice pack three to four times a day for twenty minutes at a time will help this.

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Will I have any restrictions on the day of the procedure?​ 

  • You should not drive for the remainder of the day after your procedure. An adult must be present to drive you home or to go with you in a taxi or on public transportation.

  • For your safety, the procedure will be cancelled if you do not have a responsible adult with you.

  • No heat is to be used in the injected areas for the remainder of the day. 

  • You may eat, drink and take your medications as usual on the day of the procedure (both before and after).

 

Please follow these instructions unless told differently by your doctor.For what reasons should I call the Center for Pain Medicine after the injection?If you experience severe back pain, new numbness or weakness of your legs, or signs of infection in the area of the injection, you should call the office.

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