By Dr. Adity Sharma
As a pain management physician, i specialize in the diagnosis and care of patients who suffer from chronic pain and acute pain. In fact, the neck and back are two of the most common areas that physicians treat for chronic/acute pain. At Interventional Pain Management Center (IPMC), we use radiofrequency ablation (RFA) as an effective treatment for those patients suffering with these symptoms.
Radiofrequency ablation is a minimally invasive procedure where nerves are numbed and radiofrequency creates a lesion so the nerve can no longer transmit pain signals to the brain. Radiofrequency ablation is a procedure used to mainly reduce axial pain. Axial pain is confined to a specific area such as the neck or lower back. This procedure is essentially used to treat patients with chronic, long-lasting pain in the neck and lower back. In order to be a candidate for the radiofrequency ablation you must undergo diagnostic and comparative medial branch block injections, which help to discern the source of pain or reduce inflammation and pain. A medial branch block is an injection of local anesthetic. If a patient’s pain relief is greater than 50 percent after the diagnostic and comparative medial branch block, then a radiofrequency ablation can be performed.
Radiofrequency ablation gives longer-term pain relief. Many types of chronic/acute pain respond well to RFA including, but not limited to:
- injuries such as whiplash
- neuropathic pain conditions such as complex regional pain syndrome, peripheral nerve entrapment syndromes
- prior spine surgeries
- spinal arthritis (spondylosis)
During the procedure, the patient is placed in a prone position and a fluoroscopic x-ray machine is used to visualize the spinal column and spine anatomy. After the anesthesia is used, specialized insulated needles are placed next to the nerve at the region of the facet joint. A small radiofrequency current is directed to the medial branch nerve of the joint capsule for 60 to 90 seconds. The radiofrequency waves produce heat and create a lesion in the nerve tissue that is sending the pain signals to the brain. This procedure is done with sterile technique to minimize the risk of infection. During the immediate days following the radiofrequency ablation, you may experience some soreness in the area of your treatment (which can be relieved with ice pack), which is normal. However, it is caused by muscle and nerve irritation. This healing process usually takes up to one week, but you may be able to resume everyday activities one to two days after your procedure.
One of the best features about RFA is that a patient can experience relief for six to nine months and it can be repeated in the future when needed. RFA allows a patient to feel improvement, able to continue with their daily activities, enhance the ability to straighten the back, bend and/or move more frequently without feeling any discomfort. Many of my patients have improved range of motion in the particular region being treated, and no longer wake up with severe stiffness and or pain. When combined with a moderate exercise regimen, it can last even longer. It is extremely important to build up strength and fitness gradually.
For many people, this is a life-changing procedure. Many of my patients were told they had to live with the pain because there was nothing that could be performed on them. Many of the patients felt like they were trapped or a burden to their family or friends not having someone to help them with their pain.
Patients are able to improve their quality of life after being treated with RFA. The patients no longer feel isolated because of their limitations.
Adity Sharma, M.D. is on staff at Interventional Pain Management and Ortho-Spine Center. For more information or office locations, call 800-403-1533 or visit statewidepain.com.
