Radiofrequency (RF) Lesioning
For low back or neck pain usually associated with facet joints, radiofrequency lesioning may provide pain relief.
In this outpatient procedure, specialized needles create lesions along select nerves. The needles safely heat the nerve to the temperature of hot, but not boiling, water. The heat is applied for 2-3 minutes, which blocks the nerve. In turn, this may stop the nerve from carrying pain signals to your brain.
What can I expect during the procedure?
We use x-rays to identify bony landmarks where nerves are usually found. Then we place needles in the targeted areas and apply extremely low voltages to the needle for accurate placement confirmation. Once confirmed, a small amount of local anesthetic is injected. Then a higher radiofrequency voltage is applied to the numbed area until the nerve heats up to the desired temperature.
How long is the recovery time?
After the procedure, you may feel muscle soreness for up to a week. Most patients return to work the next day. It may take 3-4 weeks before feeling pain relief.
How long does relief last?
The procedure lessens pain by blocking nerves. Generally, the body tries to re-grow blocked nerves, which takes 9-18 months. You may feel relief until the nerves re-grow. Around 70-80% of patients report a good block of the intended nerve. If pain persists after a nerve is blocked, this indicates the pain is originating from a different area.
What are the risks and side effects of RF lesioning?
Generally, this is a safe procedure. The most common side effect is temporary pain at the injection site. Very rare risks include: infection, bleeding, and nerve damage. Risks and complications depend upon the sites lesioned. The nerves to be lesioned may be near blood vessels or other nerves, which may inadvertently become damaged, but long term complications are extremely rare.
Who should not have this injection?
You should not have this procedure if you are:
- Allergic to any of the medications to be injected
- On a blood thinning medication (e.g. coumadin, injectable heparin)
- Currently battling an active infection
- On anti platelet drugs (ask your doctor if you can temporarily discontinue use before the procedure)