Minimally Invasive Techniques
Chronic pain affects millions of Americans, resulting in a loss of function and enjoyment of life. In some circumstances, surgery is not always the answer, or may be considered high risk for patients with certain health issues. Fortunately, the understanding and treatment options for chronic pain conditions has significantly advanced in recent decades. At the Center for Orthopedic Spine & Pain, we offer several minimally invasive procedures that can provide significant pain relief for a variety of painful conditions. One such procedure we offer is radiofrequency ablation (RFA). RFA is a technique in which heat energy is directed through small needles to lesion or burn the nerves that are causing your pain. Once the nerves have been lesioned, they will no longer send the pain signal to the brain. Unlike other traditional injections, RFA does not require the use of any steroid or cortisone.
Pain Relief for Multiple Conditions
RFA is a technique that we commonly utilize for neck pain, back pain, knee pain, and a few other regions of the body. For neck and back pain, RFA addresses pain from the facet joints (Fig. 1). For knee pain, RFA addresses the genicular nerves (Fig. 2). Before deciding if RFA is appropriate for your pain condition, we will first extensively review your medical records (including imaging studies), and perform a thorough physical examination at an office visit. If your pain is suspected to be caused by a condition amenable to RFA, we will likely offer you this treatment option. Depending on your clinical presentation and your insurance, we typically begin by first performing a diagnostic “test” block. The test block is a simple injection of a local anesthetic or numbing medication to the nerves we are considering for RFA. This medication will temporarily stun the nerve for a few hours, which mimics the lesioning of RFA. If the temporary relief from the test injection provides substantial benefit, we will then schedule the RFA procedure.
Long Term Results
For the majority of patients who undergo RFA, the average duration of relief is 6-8 months, though some patients receive benefit for 2+ years. If the pain returns later, this is a sign that the nerves are starting to regrow. If this is the case, RFA can easily be repeated when needed.
X-ray Guided Procedures
Most procedures we perform at the Center for Spine and Orthopaedic Pain are performed using real-time x-ray guidance. This is true for both the test injections and RFA procedures. Intravenous sedation is also available, making it a comfortable experience. The procedure typically takes less than 30 minutes, and has very minimal recovery time.