Radiofrequency Ablation for Chronic Neck and Back Pain in Houston

Radiofrequency ablation is one of the latest medical procedures available to manage neck and back pain. Minimally invasive and offering lasting pain relief, the technique significantly decreases pain severity and subdue the recurrently bothering neck and back soreness linked to facet joints.

It is mostly used by Houston pain management doctors to provide relief for chronic neck and back pain. Performed as an outpatient procedure, radiofrequency ablation is covered by most insurers.

What is Radiofrequency Ablation?

Radiofrequency ablation refers to use of heat generated from electric current to stun pain sending signals. Also known as radiofrequency neurotomy and radiofrequency lesioning, the process involves denervation through electromagnetic waves emitting heat energy at very high frequencies.

When this heat energy is accurately administered to the nerve tissues experiencing the soreness, the pain signals emanating from that area are inhibited. This semi-permanent disruption of nerve conduction through radio waves assures pain control for a longer period, from a few months to a few years.

How Does Radiofrequency Ablation Relieve Pain?

Radiofrequency ablation is based on the principle of interrupting nerve conduction through controlled delivery of heat. We are aware that electric current or direct electromagnetic wave has the potential to destruct the nerves. But when radiofrequency waves are used in short pulses, they only stun the nerves and disrupt their conduction, but do not destroy them.

Pulsed radiofrequency delivered at 500,000 cycles per second is known to ablate the nerve tissues. The low temperature generated, usually around 45 to 70 degrees Celsius do not damage them, but “shut off” their pain transmission ability. This provides nerve block and pain relief for a longer period of time.

When Patients Require Radiofrequency Ablation for Neck and Back Pain? What Conditions Are Treated Through Radiofrequency Ablation for Neck and Back Pain?

Radiofrequency ablation treatment is best suitable to manage chronic pain caused by any of the following conditions.

  • Neck pain
  • Chronic pain in the mid and lower back area
  • A typical facial pain linked to sphenopalatine ganglion
  • Facet joint disease causing neck and back pain
  • Peripheral neuropathy or pain caused by damage to peripheral nerves
  • Sympathetically mediated pain due to nervous disorder linked to fracture, stress, sprain, or similar physical conditions
  • Complex regional pain syndrome
  • Trigeminal neuralgia due to neuropathic disorder impacting the fifth cranial nerve and causing extreme facial pain
  • Acute or cluster headaches
  • Stroke-related pain
  • IDET or uncontrolled back pain despite conservative pain management
  • Disc denervation or discogenic pain
  • Reflex sympathetic dystrophy impacting upper or lower extremities
  • Occipital neuralgia
  • Spondylolysis or vertebra defect
  • Sacroiliac joint dysfunction
  • Abdominal pain traced to visceral nerves
  • Arthritis of the spine

How Is Radiofrequency Ablation Performed?

Radiofrequency ablation is typically used as a follow-up method to prevent wearing off of a facet block or a medial branch block and prolong its effects. The procedure involves three stages.

  • First, patients are advised to lie on an x-ray table and administered a local anesthetic to numb the focused pain area. Many prefer to inject intravenous sedatives to relax patients, but this is not essential.
  • Second, a needle is inserted into the numbed skin under fluoroscopic guidance. The accurate position of the needle and no threat to blood vessels are confirmed through contrast dye injection.
  • Third, a microelectrode is inserted into the needle. If the patients feel tingling sensation, the electrode is thought to be positioned exactly. And radiofrequency ablation therapy is administered with pulsed radio waves delivered to heat the nerves.

Doctors also ensure that the needle does not deliver radio waves to an actual nerve root. Only sensory nerves are aimed at and motor nerves are left untouched. Heat and duration vary according to the pain area focused and condition of the patient.

How Long Does It Take?

Radiofrequency ablation therapy takes between 45 to 60 minutes. The exact procedure is completed within 20 to 30 minutes with radio wave heat administration averaging 90 seconds. Doctors usually keep the patient under observation for about 30 minutes.

Do I Need Rest After Radiofrequency Ablation?

You can go home if there is no unusual sign during the observation period. It is an outpatient procedure and does not require any special care. However, it is advisable to have rest and relaxation for afew hours after radiofrequency ablation.

How Long the Effects Of Radiofrequency Ablation Last?

Radiofrequency ablation has atypical range of pain relief for six to 12 months depending on pain location and patient condition. Clinical and research studies have confirmed that it may be effective for years. A majority of patients have successful pain relief that lasts up to 2 years.

Why Is Radiofrequency Ablation procedure Used To Prolong Pain Relief? How?

 

Radiofrequency ablation is utilized to prolong the efficacy of other nervous block pain management procedures, mostly used to treat facet or medial branch nerves and spine. This reinforces blocks achieved using injection-assisted or other numbing methods. It has been found that the treatment for facet syndrome/ arthritis assures greater success when injection block is combined with radiofrequency ablation.

Facet joint pains occur due to trauma, stress, whiplash injury, cartilage damage, or degenerative disorders. This results in inflammation of these joints bordering the spinal cord throughout its length from neck to lower back.

Patients undergo blocking therapy using injections of numbing medication or other types of nervous block. However, the effects wear off with time. Researchers have discovered that using radiofrequency ablation as a follow-up to block therapy, the pain relief can be enhanced significantly. Both combined together assures pain relief for years without any invasive intervention.

How Many Radiofrequency Ablation Procedures Should I Have?

Radiofrequency ablation is a semi-permanent pain relief procedure. The relief varies from patient to patient. The nerves remain numb for an extended period, between six months to two years. You may undergo a repeat ablation after that.

Those with multiple requirements for radiofrequency ablation therapy are advised to consult doctor about the necessary gap required between two procedures for two different levels. Doctors can treat multiple levels subject to the condition of the patient and his or her response to the treatment.

What Are The Side Effects of Radiofrequency Ablation?

Radiofrequency ablation treatment is generally safe. There is slight risk of introducer needle-related bleeding, short-term soreness, and temporary infection, but it is well-tolerated by most men and women. Patients may experience weakness in legs, injection-site bruises, discomfort, and swelling for a day or two. But these effects wither away soon. It is not recommended for those already with active infections or bleeding problems.

Depending on the therapy area, patients may develop side effects and complications, unless it is done by specialist. Such risks include blood vessel rupture and electrical burn. If motor nerves are damaged, complications, including spinal cord trauma, may occur.

How Well Does Radiofrequency Ablation Work? What Are The Benefits of Radiofrequency Ablation?

  • According to a 2005 report in the Pain Practice journal, radiofrequency ablation is able to significantly reduce neck and back pain in patients without side effects. It found complete pain reduction for 21 percent interviewed and moderate success in 65 percent cases.
  • The Best Practice & Research Clinical Anaesthesiology journal claims that the therapy plays “an important role in the management of trigeminal neuralgia, nerve root and spinal pain.”
  • According to a 2001 Arquivos de Neuro-Psiquiatria research report, radiofrequency ablation is 92.5 percent effective for trigeminal neuralgia.
  • Clinical studies have attested the efficacy of radiofrequency ablation for neck and back pain relief between 50 percent and 90 percent over six to 24 months. In 2007, a Clinical Journal of Pain report claimed “significant pain relief and functional improvement” due to such treatment of back pain for 18 months.
  • Studies have also indicated benefit for knee pain (Pain journal, 2011), cervicogenic headaches (Clinical and Experimental Rheumatology, 2000), discogenic pain, sacroiliitis (Anesthesiology, 2008), and occipital neuralgia (Clinical Neurology and Neurosurgery, 1992)

References

Sphenopalatine ganglion pulsed radiofrequency treatment in 30 patients suffering from chronic face and head pain. Bayer E, Racz GB, Miles D, Heavner J. Pain Pract. 2005 Sep;5(3):223-7

Lord SM, Bogduk N. Radiofrequency procedures in chronic pain. Best Pract Res Clin Anaesthesiol. 2002 Dec;16(4):597- 617.

Radiofrequency-thermocoagulation in the treatment of trigeminal neuralgia: analysis of 100 cases Motta P, de Souza MT, Sengupta RP. Arq Neuropsiquiatr. 1980 Mar;38(1):33-44

Sphenopalatine ganglion pulsed radiofrequency treatment in 30 patients suffering from chronic face and head pain. Bayer E, Racz GB, Miles D, Heavner J. Pain Pract. 2005 Sep;5(3):223-7

Tekin I, Mirzai H, Ok G, et al.: A comparison of conventional and pulsed radiofrequency denervation in the treatment of chronic facet joint pain. Clin J Pain. 2007; 23 (6):524-529.

Choi WJ, Hwang SJ, Song JG, et al. Radiofrequency treatment relieves chronic knee osteoarthritis pain: a double-blind randomized controlled trial. Pain. 2011; 152: 481-7.

van Suijlekom JA, Weber WE, van Kleef M: Cervicogenic headache. techniques of diagnostic nerve blocks Clin Exp Rheumatol. 2000; 18:S39-S44.

Anthony M: Headache and the greater occipital nerve. Clin Neurol Neurosurg. 1992; 94:297-301.

Cohen, S., Hurley, R., Buckenmaier, C., Kurihara, C., Morlando, B., Dragovich, A., Randomized placebo-controlled study evaluating lateral branch radiofrequency denervation for sacroiliac joint pain. Anesthesiology, 2008; 109: 279-287.

Burnham RS, Yasui Y. An alternate method of radiofrequency neurotomy of the sacroiliac joint: a pilot study of the effect on pain, function, and satisfaction. Reg Anesth Pain Med. 2007 Jan-Feb;32(1):12-9.

Arora R. Radiofrequency neuroablation in chronic low back pain. Practical Pain Management. 2005 March;18-20.