Pain can be complex — but treatments are available. Find out how RFA could be a treatment for your chronic pain.
by Featured Provider Arpan Patel on Monday, March 27, 2023
Living with day-to-day pain can be debilitating, especially when it prevents you from doing the things you love. When your body hurts, not only do you want relief, but the most effective treatment possible. Luckily, Iowa Clinic Pain Management providers Dr. Arpan Patel and Dr. Jun Xu have advanced training in treating your pain using radiofrequency ablation — a minimally invasive procedure for pain relief.
RFA is commonly misconstrued as a surgery, which it is not. There is no cutting or anesthesia required and can be done in an office in less than an hour. RFA is a treatment that has been available and researched for nearly 30 years — with technique and equipment significantly improving over time.
Radiofrequency Ablation for Pain Management
There are two broad categories of nerves in our body — sensory branches (helps us feel) and motor branches (help us move). During an RFA procedure, the sensory branch that supplies the pain is targeted and burned away, specifically at the facet joint. RFA works to reduce relieving pain in various areas, including:
- Nerve Pain
What to Expect During an RFA Procedure
Your provider will begin with an intravenous anesthetic to keep you comfortable. While laying on your stomach (or back, depending on treatment area), your provider will direct a needle into the treatment area. A probe will then be inserted into the needle and parked next to the targeted nerve. The needle tip then heats up along the side, burning the damaged nerve, which prevents or stops the pain signal from reaching the brain and results in pain relief. Nearby healthy nerves are not damaged during this procedure.
Pain relief lasts anywhere from nine months to two years, which helps decrease the need for long-term pain medication and other interventional procedures. Nerves are always regenerating, which means the burned nerves could grow back — but RFA is a repeatable procedure to relieve this pain.
Commonly Asked Questions
How Do You Prevent Paralysis?
This is prevented through a step called sensory and motor testing. When the needle is in the right spot, the machine is used to provide some stimulation to the patient that feels like pressure, tingle, or a twitch — but does not hurt. When you are stimulated, you will be asked a series of yes or no questions, and depending on what you feel, nerves are mapped out to make fine tune adjustments to the needle to be next to the sensory nerve and away from the motor nerve.
Will This Help My Leg Pain?
The short answer is no, RFA will not help leg pain. Typically, pain in the legs happens from nerve compression in the low back from disc herniations or stenosis at motor branches — which are not burned in RFA.
Why Can’t I Just Get an Injection?
Steroid injections are an option but given arthritis doesn’t heal or go away with time, injections typically wear off in three months or less. With RFA, you can get 6-18 months of relief or more without repeated steroid injections. The ablation can be repeated in the future when the pain returns.
So, The Pain Comes Back — Why Doesn’t This Last Forever?
Yes, the pain can come back because the nerves that are burned grow back. Sometimes, the pain comes back, but is not nearly as bad as when you started the process. If the pain does return, you and your provider can decide if repeat ablation is needed depending on how you’re doing overall.
Can I Get Surgery to Fix the Problem Once and For All?
Based on data we have today, surgeons typically operate for pain in the extremities only, or nerve compression at the motor branch. If that is your primary issue, then surgery may be an option for you. However, if you mostly have pain in the neck, mid-back, or low-back, surgery is typically not an option. If you’ve already had back surgery, you may still be a candidate for an ablation, depending on the type of surgery you had.
How Can You Tell If This Is Right for Me?
A simple x-ray of the part of the spine that is painful is enough to tell whether RFA is right for you. Through imaging, any bone slippage or shifting in the spine will be shown. An MRI or CT can help your provider give you a better opinion on other types of nerve compression that cause pain in the arms and legs but isn’t required for an RFA evaluation.
When other treatments aren’t working — but you don’t want surgery — radiofrequency ablation could be a great option for you. Individual results vary, but you could enjoy lasting pain relief for 6-18 months — or even longer.
Talk with your healthcare provider to see if RFA is the right treatment for your chronic pain. To learn more about the services and treatments of our Pain Management department, visit our website or call 515.875.9902.