Technique
Radiofrequency ablation (RFA) is a minimally invasive procedure for pain relief. It works by using heat to damage or modulate specific nerves that carry pain signals, stopping the pain where it starts and preventing the pain signals reaching your brain. We can target the nerves of your spine, joints, trapped nerves, or can ablate selected benign and malignant bone lesions.
Radiofrequency ablation is performed as an outpatient procedure in the imaging suite under local anaesthetic or with some sedation, sometimes needing a general anaesthetic.
Applications
RF nerve ablation can be performed in the spine for facet joint pain (rhizolysis) or even degenerative disc pain (basivertebral nerve ablation). We also routinely treat nerves around the shoulder (supraspacular), knee (geniculates), thigh (lateral femoral cutaneous), groin or perineum (pudendal) or those with neuromas, including after amputation. This is done under image guidance (ultrasound, fluoroscopic or CT) to ensure the nerves are carefully targeted.
If the ablation is for symptomatic relief of painful benign or malignant bone lesions such as in metastatic cancer, the case is discussed in the Oxford regional bone and soft tissue tumour multidisciplinary meeting before proceeding.
Patient information
Before being considered for an ablation, some patients would have a diagnostic nerve block injection to check the treatment will relieve their pain. This is often helpful but does not last as long as the ablation. After treatment, the nerves eventually regenerate, although the procedure can give up to 2 years of pain relief.
There may be some pain near the injection site after the ablation procedure, but this is usually easily remedied with ice packs and over-the-counter medications. Patients should rest for a few days afterward and avoid strenuous activities. If you have a pacemaker or implantable electronic device (e.g. pumps, stimulators, cochlear implants) then we can discuss other options, including ‘cryoneurolysis’, which is similar but uses a freezing thermal effect.
