Coastal Spine is focused entirely on treatment of the neck and spine. Sometimes, we will need to alleviate the existing pain before you can work on physical therapy and other Minimally invasive therapies with a variety of treatments.
One of the ways we attempt to alleviate neck and spine distress is through a radiofrequency ablation procedure. In some cases, this treatment can provide longer-term pain relief than an injection. Radiofrequency is an option for patients where injections have not worked or for those in chronic pain.
Why is radiofrequency ablation done?
Chronic back pain can be difficult to accurately pinpoint the origin. That’s why surgery can sometimes not be successful in fully eliminating pain.
There are numerous advantages to using these treatments for chronic back pain. First, the patient can avoid surgery, which presents far more risk and involved recovery times. Recovery from radiofrequency ablation itself is short, with most patients returning to their normal activities in just 1-3 days after the procedure. These treatments allow patients to dramatically decrease their reliance on pain medication. They allow the patient to improve movement and function, which improves their quality of life. Radiofrequency ablation can also be repeated if the nerve regenerates after ablation, which typically happens in from 6 months to 2 years.
Who is a good candidate to have radiofrequency ablation?
Radiofrequency ablation is a treatment option for patients who have experienced successful pain relief after a diagnostic nerve/pain receptor block injection. This shows that their pain is being caused by nerve compression where a nerve or nerve root is exiting the spine.
These treatments are an option for most people. The only people who cannot have radiofrequency ablation are people with an active infection, pregnant women, or those with a history of bleeding problems.
What are the side effects of radiofrequency ablation for back pain?
These are low-risk treatments. It has been proven to be effective for treating chronic back pain that can be traced to a nerve or nerves in a certain area of the spine. The procedure does involve the insertion of the radiofrequency needle, so there is a slight risk of bleeding and subsequent infection, but these risks are quite low.
After these treatments at Coastal Spine, patients can expect some discomfort from the treated nerve. This isn’t a sign of failure. It actually can be a clue that the offending nerve has been correctly targeted. Many patients can return to work in just 1 to 3 days, and pain improves significantly in most patients by day 10 after their ablation. This is moderate discomfort, and it doesn’t occur in all patients who have had this treatment.
What are the limitations of radiofrequency ablation?
These are effective treatments with little risk. They can also be repeated. But there are limitations. The main limitation is that the procedure isn’t sure to provide the pain relief intended. In radiofrequency ablation for facet joints, the success rates (meaning the patient’s pain is reduced) are 45 to 60 percent. In the sacroiliac joint, pain relief occurs in from 75 to 86 percent of patients.
Also, the ablated nerve can regenerate and begin sending pain signals once again. This usually occurs in from 6 months to 2 years, although there are some examples of pain relief for up to 3 years. Although this is a limitation, the earlier success means the impacted nerve will likely respond to ablation again in a repeat procedure.
When are radiofrequency Ablation Injections used?
Coastal Spine uses epidural steroid injections in two situations:
Radiofrequency ablation procedures can provide relief that will help patients undergo rehabilitation without battling through otherwise acute pain and inflammation.
Several common conditions, including chronic spinal pain, spondylosis, trauma and post-surgical pain, can cause severe to acute low back and/or leg pain. For these and other conditions that can cause chronic pain, radiofrequency ablation may be an effective Minimally invasive treatment option.
The procedure typically takes about 20 minutes to an hour and is performed under mild sedation. After the recovery time, the patient is required to have a driver for transportation home.
How is radiofrequency ablation performed?
These treatments are performed with the patient under IV sedation. The area to be treated is then locally anesthetized. Patients are awake during the procedure.
Once the patient is fully anesthetized, your Coastal Spine doctor will use x-ray guidance to insert the radiofrequency needle into the target area where the nerves are causing the patient’s pain. With the needle in the correct position, a mild electrical current is then passed through the needle to verify that the position is indeed correct. If the placement is correct, the electrical current will briefly create a tingling sensation and may cause a muscle twitch in the neck or back. Once we have verified the correct placement, we’ll place additional local anesthetic in the area to keep the patient comfortable.
Now, it’s time to deaden the offending nerves. Radiofrequency currents are passed through the needle, creating a lesion on the nerve. This lesion disrupts the pain signals sent to the brain. Your Coastal Spine doctor repeats this process for any additional nerves that are causing pain.
What is the success rate for radiofrequency ablation for back or neck pain?
Success can vary between patients. This seems to be related to the area of the spine being treated. In many patients, they experience pain relief that lasts from 6 months to a full year. In fewer patients, this can alleviate their pain for years or even permanently.
Research on radiofrequency ablation for nerve pain shows a success rate of 70 to 80 percent with a single treatment. This means a reduction in pain. If necessary, in the future the procedure can be repeated on the same area.
"Very good physicians with a great group of staff. They are very caring and go the extra mile. The doctor spent a lot of time describing my problem and everyone was very helpful."