Radio Frequency Ablation (RFA)

What is Radio Frequency Ablation?

Radio Frequency Ablation (RFA) is an interventional procedure used to treat chronic pain.

RFA can be used to treat a variety of conditions by disrupting the nerve signals and reducing the patient’s pain.

RFA can be used to treat chronic back pain due to facet arthropathy, end stage osteoarthritis and sacroiliac joint pain.

What happens during a RFA?
A Radiologist specialising in RFA will perform the procedure under CT guidance. The patient is positioned according to the area to be treated. A diathermy pad is placed on the opposite thigh to where the procedure is being performed. The area is covered with sterile drapes and washed with an antiseptic solution. After the administration of superficial and deep local anaesthetic, a fine needle is positioned upon the nerve to be treated under imaging guidance. A thin wire (probe) is then passed through the needle sheath. The position of the probe is very important in spinal RFA it is checked by sensation and motor tests.

  • Sensation – you may feel tightness, pressure or tingling in your back
  • Motor – you may feel some throbbing in your back. Depending on the extent of the throbbing the probe may be re-positioned.

The probe has an electrode on its tip that is connected to a radiofrequency generator. When the probe is in the correct place, the tip is then heated to 40-80 degrees centigrade and the radiofrequency generator produces a high frequency alternating current that will cause tissue to heat up in the vicinity of the electrode.
The current is such that it will cause a ‘burn’ to the nerve, hence causing interruption of nerve signals.
Local anaesthetic and steroid is injected after the probe has been heated to relieve discomfort following the procedure. The procedure takes approximately 30 minutes plus recovery time.

Post Procedure Care
If you already have a good response to diagnostic injections, RFA offers you a realistic chance of good long term pain relief. Usually you will notice results in the first few days. Symptoms can be relieved for up to a year or longer in about 50% of all patients. Unfortunately, the nerve can regenerate so your pain may return but a repeated procedure is likely to be beneficial if you respond to the first treatment.

  • It is preferable to have someone take you home
  • There may be a slight soreness or bruising at the needle site. Paracetamol and or ice may provide some comfort if required.
  • You should not participate in strenuous activity or exercise for 48 hours to one week depending on your treating Doctor’s instructions. They will also advise you on how best to resume pre-treatment activity levels.
  • If you experience any fever, localised heat, swelling or increasing pain more than 48 hours after the injection you should call our clinic or consult your referring Doctor without delay.

Are there any risks or side effects?
There are risks and side effects associated with any treatment. In general the risk is low, but includes:

  • More discomfort for the first few days after your injection
  • Bruising to the injection area
  • Infection
  • Leg numbness and weakness are very rare side effects
  • Reactions associated with the injected steroid such as facial flushing for a few days, difficulty sleeping and temporary increase in your sugar levels (diabetics)