Radiofrequency ablation (RFA) is a minimally invasive treatment that can sometimes relieve chronic back pain. During the procedure, a doctor inserts a thin metal probe into the painful area. The probe emits radiofrequency energy that creates heat and destroys the nerve tissue that is causing pain.
RFA is a relatively new procedure, though researchers have yet to fully learn its long-term results. However, most people who have undergone RFA report significant pain relief.
There are some risks relating to RFA, including bleeding, infection, and nerve damage. However, these complications are rare, and most people do not experience any problems after RFA.
This article looks at the results and risks associated with RFA for back pain. It also covers what to expect during recovery.
What is RFA?
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RFA uses thermal energy waves to heat and destroy a small area of nerve tissue. This means the nerve cannot send pain signals to the brain, resulting in reduced or eliminated back pain.
The procedure involves guiding a small needle or probe into the skin and toward the source of the pain. Once in place, the probe delivers radiofrequency energy to the treatment site.
The thermal energy this creates destroys tissue, and doctors use it to target the nerve cells responsible for transmitting or modulating the sensation of pain.
RFA is a minimally invasive procedure that does not require general anesthesia. People can undergo this treatment as an outpatient procedure, so they can go home the same day.
How does RFA help with back pain?
RFA is a common treatment for low back pain with several benefits. It may:
- reduce or eliminate chronic back pain by interrupting pain signals
- improve a person’s ability to function, allowing them to perform activities they previously found painful
- allow someone to take fewer pain medications
- allow a person to avoid or delay more invasive surgery
Some people may also prefer RFA to other treatment options, as it is noninvasive, has minimal recovery times, and can provide near-immediate pain relief.
The RFA procedure
RFA does not require general anesthesia, but a person may receive medication to help them relax.
The RFA procedure is as follows:
- The surgical team will clean the skin around the insertion site and use a local anesthetic to numb the area.
- They will then insert a needle or tube, known as a cannula, into the affected area.
- They then pass the needle to the correct position under X-ray (fluoroscopy) guidance.
- Once in position, the needle emits a radiofrequency current that heats the affected area and destroys the nerve cells responsible for transmitting pain signals to the brain. The procedure takes 1–2 hours.
After the procedure, the person may stay in the hospital for observation before going home. They should arrange for transport home so that they do not have to drive.
Recovery from RFA
It is common to experience some discomfort or soreness after RFA, but this usually subsides over the next few days. A person may need to rest and avoid activities that hurt until this gets better. People can take over-the-counter pain medications, if necessary, with their doctor’s approval.
Most people can return to their typical activities quickly, but they should consult their doctor before resuming strenuous activities or exercise.
Success rates for RFA
Low back pain can originate from various places. The success rate of RFA may depend on the underlying cause of the pain, the accuracy of diagnosis, variations in nerve anatomy, the technique a surgeon uses, and other factors.
That said, studies tend to show favorable results. For example, a small 2020 study looked at 30 people with back pain due to problems with the discs between bones in the spine. The researchers found that:
- 17 individuals had excellent outcomes
- 11 had good outcomes
- 2 had fair outcomes
Similarly, it appears that RFA is valuable for treating sacroiliac joint pain, providing pain relief in around 75% of people in an older 2016 study.
However, both of these studies were small. Larger trials are necessary to determine how effective RFA is for different types of back pain.
It is also important to note that the nerves RFA destroys will eventually regenerate. Sometimes, this means the pain comes back, but not always.
Risks and side effects of RFA
Doctors consider RFA a low risk procedure. Complications can occur, but they are uncommon.
Most complications from RFA are minor and short term, such as swelling, bruising, and pain at the insertion site. Other side effects that require additional treatment include:
- bleeding
- infection
- nerve damage due to needle placement
- burns
Cost and insurance
The cost to someone needing RFA may vary depending on several factors, including:
- the clinic or doctor
- location
- the complexity of the individual’s case
- whether they have health insurance
Some insurers cover RFA for back pain, but in some cases, they may only do so if the person has tried other treatments that have been ineffective. People can check with their insurer to see if their policy covers the procedure.
Individuals without insurance may need to pay upfront for RFA, which can cost several thousand dollars. It is best to consult a doctor and ask about any available payment plans.
Summary
RFA is a minimally invasive procedure that doctors use to treat chronic back pain. It is a relatively quick procedure that does not require general anesthesia or a hospital stay. Recovery time is minimal, but people may experience some discomfort for a short time afterward.
The procedure is generally low risk, but complications can occur. These are typically minor and temporary and can include swelling, bruising, and pain at the insertion site. Success rates vary depending on the underlying cause of pain and other factors.
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