Radiofrequency Ablation in Baton Rouge

Ablation is a process by which extreme temperatures (high or low) are used to destroy some sort of problematic or abnormal tissue. In the case of radiofrequency ablation (RFA) for back or neck pain, heat is used to kill a portion of nerve tissue, thereby preventing it from transmitting pain signals. These nerves may be located in the sacroiliac joints (SI joints) of the pelvis or the vertebral facet joints.

There are three different types of RFA that may be used to address back or neck pain. These are:

• Conventional or Thermal RFA – This classic version of the RFA procedures delivers a steady radiofrequency current to the nerve via a needle. This needle will reach temperatures of 140 to 176 degrees and create a small lesion on the nerve tissue.
  
  
• Pulsed RFA – As opposed to conventional RFA, pulsed RFA uses a radiofrequency current but delivers it in short bursts. It also operates at a lower temperature, reaching about 107 degrees Fahrenheit.
  
  
• Water-Cooled RFA – Like conventional RFA, this option delivers a continuous radiofrequency current heated to about 140 degrees. However, it uses a multi-channel electrode which also delivers a flow of water continuously, preventing the needle from overheating.
  

RFA can be classified into two types: lateral branch RFA and medial branch RFA. Lateral branch RFA addresses nerves of the SI joints, while medial branch RFA addresses nerves of the facet joints. Between the two, they can be used to treat conditions such as:

• Back or neck pain resulting from a spinal condition like spondylosis
  
  
• Headaches resulting from referred pain from the neck (cervicogenic headache)
  
  
• Head or occipital pain resulting from a pinched C2 or C3 nerve (occipital neuralgia)
  
  
• Pain in the SI joint or posterior pelvis region
  

Radiofrequency ablation is typically used after other treatment options have failed to provide adequate relief. If you suffer from any of the above conditions and have not had good results from methods such as spinal injections, pain medication, and orthopedic physical therapy, RFA may be a logical next step. Patients who should not receive RFA include those with infection in the area of planned injection, those who have increased intracranial pressure, or who have an allergy to the anesthetic used in the procedure.

RFAs are performed as outpatient procedures. With the patient on their stomach, the area of the incision is thoroughly cleaned and local anesthetic injected. Once the site has been fully prepped, the needle is inserted and guided toward the target nerve area using fluoroscopy, or x-ray technology, to guide it into place. Once in place, the electrode can be passed through the needle directly to the target nerve. Then, the process of conventional, pulse, or water-cooled ablation can begin.

RFA is a quick procedure, taking only 30 to 90 minutes to complete. Afterwards, the patient will remain in a recovery room for up to an hour for observation. Once released, patients are typically advised to use ice packs for pain and swelling, avoid baths for the first couple of days, and to rest for several days. Normal activity can be gradually resumed based on pain levels.

Side effects of RFA are rare. When they do occur, they are typically mild and short-lived. Most commonly, patients my experience increased skin sensitivity or a numbing, tingling, or burning sensation at the injection site. These symptoms will likely resolve in a matter of days. Far less common side effects or risks include infection at the insertion site and heat damage to other tissues close to the nerve. Each of these can be easily avoided by selecting a qualified and experienced practitioner for the procedure.

RFA has a very high success rate and will alleviate pain for most patients for years. In some cases, the nerve may regenerate. Should a patient’s pain return, the procedure may be repeated.

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