Definition & Overview
Radiofrequency block, also referred to as a radiofrequency nerve block, radiofrequency lesioning, or radiofrequency ablation, is a procedure to reduce neck and back pain using radio waves. It effectively reduces pain for a period of 6-9 months, after which it will need to be repeated.
Intense neck and back pains are usually a result of the inflammation of the facet joints located between the vertebrae of the spinal column typically due to injury or diseases. Nerves located at the facet joints carry pain signals to the brain when the joints are irritated.
A radiofrequency block prevents the pain signals from reaching the brain, but this procedure is only performed when other forms of pain relief treatments have failed.
Who Should Undergo & Expected Results
Back and neck pains can be so intense that they can severely limit a person’s movements, even to the point of immobilization. Pain relief medications are usually the first line of defense, but in cases where other forms of treatment proved to be ineffective, a radiofrequency block is typically recommended by doctors. The procedure is ideal for those who suffer from intense and chronic pain caused by injuries or whiplash, prior spine injuries, spinal arthritis or neuropathic pain conditions.
The procedure is usually recommended for patients who experience:
- Pain in one or both sides of their backs
- Pain that originates all the way to the thighs but does not go past the knees
- Pain that worsens when twisting the body or lifting objects
Although a radiofrequency block is generally effective in providing pain relief, the effects differ from person to person. The procedure may be more effective for some patients, but less so for others. It is worth nothing that no doctor can accurately predict the level of pain relief a patient may achieve from the procedure.
How Does the Procedure Work?
The entire procedure may only take a couple of hours to complete and is usually performed on an outpatient basis. Prior to the procedure, several tests will be conducted to determine if the patient qualifies for the treatment.
The success of the procedure relies heavily on the ability of the doctor to locate the exact nerves responsible for the pain. The test involves injecting numbing medications into the nerves that the doctor believes to deliver pain signals to the brain. The patient is deemed a good candidate for the procedure if the pain is significantly reduced following the injection of the numbing medication.
Although a radiofrequency block is considered to be an outpatient procedure, it requires preparation. Patients will be instructed to:
- Avoid tobacco products or chewing gum on the day of the appointment
- Refrain from using perfumes or lotions prior to the procedure
- Any medications should be taken at least two hours before the procedure
- Arrange for someone to take the patient home
On the day of the appointment, the patient will be asked to wear a hospital gown and to lie face down on an x-ray table. An x-ray device called a fluoroscope will be used by the doctor to correctly identify the exact nerves and to guide the needles into their proper places.
Most patients who undergo the procedure feel some degree of anxiety. If requested, the doctor can provide medications intravenously to keep them comfortable and calm. The doctor will also inject numbing medications on the area of the skin where the needles will be placed, making the procedure painless.
Once the needles have been inserted, radio waves will be delivered through them to prevent pain signals from passing through the nerves and reaching the brain.
When the doctor determines that the procedure was successful, the patient will be transferred to a recovery area where he can rest for a while before going home. The area where the needles were inserted will be sore for some time, but ice packs should be able to provide some relief. The patient will then be instructed to avoid taking a bath or shower for at least 24 hours after the procedure.
Pain relief achieved through a radiofrequency block is only temporary, but it should last anywhere between 6 to 9 months. Once the effects subside, the patient may elect to undergo the same procedure again.
Possible Risks and Complications
Any type of medical procedure has an associated risk or possibility of complications, more so if done on the spinal column. The immediate side effects of a radiofrequency block are temporary numbness or pain at the injected site.
There is also a possibility of more serious side effects or complications. There have been reported cases of paralysis, bleeding, nerve injury, infections, or numbness that lasts longer than expected.
- Society of Interventional Radiology