Radiofrequency ablation, also called rhizolysis, is a procedure used to provide longer lasting pain relief than nerve blocks.
What is radiofrequency?
Most patients who are going to undergo radiofrequency have already had a previous block such as facet joint or posterior median nerve injection of the facet joint, anesthetic sympathetic nerve block, or other nerve blocks, with short-lasting pain relief.
By producing a lesion of the nerves that transmit pain signals, the structure or cause of the pain can be denervated and the pain reduced or eliminated with a variable duration, but generally for several months.
What is radiofrequency?
Radiofrequency consists of the use of electromagnetic waves at a very high frequency (25000 Hz) at specific points, usually next to specific nerves, to produce a thermal energy or lesion, which alters the nerve and allows pain relief. This is produced by a specialized generator.
Types of radiofrequency:
- Conventional radiofrequency: a temperature of 80° is applied for 90 seconds next to the nerve.
- Pulsed radiofrequency: based on the use of repeated pulses of radiofrequency, without exceeding a temperature of 42°, applied to a nerve.
Radiofrequency applications
Radiofrequency can be applied to a multitude of chronic pain conditions and also in other specialties such as traumatology, general surgery or otorhinolaryngology.
It can be effective, for example, in chronic back pain, including lumbar or cervical spondyloarthrosis, post-traumatic pain (whiplash syndrome), pain after spinal surgery, and other spinal pain conditions.
Other conditions known to respond well to RF include some neuropathic pain pathologies, such as complex regional pain syndrome (also called sympathetic-reflex dystrophy), trigeminal neuralgia or cluster headache or peripheral nerve entrapment syndromes.
Risks of radiofrequency
There is a very rare risk of infection or bleeding in the treated area. For this reason it is normally performed in the operating room, with adequate sterility means and with control of the patient’s vital signs.
There is also the possibility of nerve damage, although in the hands of an experienced Pain Unit specialist this is very rare. The patient, however, may be sore for a few days after treatment, which may be up to 1 week, before experiencing improvement, which in some cases may take 3-4 weeks.