Radiofrequency Neurolysis/Ablation

What is Radiofrequency Neurolysis?

Radiofrequency neurolysis also called ablation, denervation, rhizotomy, etc. is a safe and effective technique used in pain management to desensitize specific nerves and reduce pain impulses using radio waves. It is used to treat certain neck, arm, back or leg pain problems after the cause of the pain has been identified.

How should I prepare for the procedure?

• Your surgeon will discuss the preoperative guidelines. Follow your surgeon’s instructions. These instructions may include:
  • Do not eat or drink for at least eight (8) hours before the procedure. You will be able to take your usual medication with a small amount of water. If you have diabetes, do not take your insulin or diabetic pills until after the procedure.
  • You will need a driver to take you home.
    Do not take any aspirin or aspirin-containing medication at least eleven days before the procedure. They may prolong bleeding.
  • Wear loose fitting clothing that is easy to take off and put on.
  • Take a shower the morning of the procedure, using a bactericidal soap to reduce chances of infection.
    Do not wear jewelry.

Procedure:

Radiofrequency neurolysis or lesioning is performed on an outpatient basis with monitoring and if needed, sedation. RF procedures such as facet RF denervation are typically preceded by a diagnostic block to ensure at least 50% reduction in pain on injection of a local anesthetic into the area.The diagnostic block and the therapeutic RF procedures are usually performed at two separate sessions to assure accuracy.

Most patients feel mild discomfort only during the placement of the needle. After that, local anesthetic is used to prevent pain.The procedure is done under local anesthesia, under conscious sedation, since you will need to be able to tell your doctor what you are feeling to improve the results of the test.

After sterilizing the area, a small amount of local anesthetic is used to numb the skin. Then, small hollow needles are inserted in the numbed area to the desired locations using x-ray (fluoroscopy) to ensure precise placement of the needle. A probe, attached to a radiofrequency generator, is then inserted through one or more of the hollow needles. Then, radio waves produced by the radiofrequency generator are used to desensitize the nerves that are contributing to the pain you are experiencing.

The procedure usually takes 10 to 45 minutes, depending on the number of levels to be done and is followed by a short observation period.

Post-Procedure/Follow-up:

Patients usually are instructed to take it easy the day of the procedure, while the UPC doctor will provide specific activity restrictions as indicated, some of the common recommendations are listed below. As always, feel free to ask our staff if you have any additional questions or concerns.

• Avoid being on your feet for 2-3 hours following the injection, and do not drive or operate dangerous equipment or machinery during this time.
• Notify the UPC staff if you experience persistent pain at the injection site, headache that is worse when sitting or standing upright, fever, chills, dizziness, or leg or arm numbness that lasts more than 2-3 hours.
• A drop or two of blood at the injection site is normal. However, you should contact the UPC office if you experience persistent bleeding or drainage at the injection site and then follow all of their instructions for further care.
• Results from the injection usually occur within 2-5 days and you may experience continued improvement over the next several days. Full benefit may take longer (ie two weeks). The UPC Pain specialist will instruct you regarding whether you should take any other pain medications during this time.
• Contact the UPC staff if you have any additional questions or concerns.
• It may take several weeks before the results are known, but most patients notice improvement in 2 weeks.