How it works
How radiofrequency ablation works
RFA uses an electric current to heat a small area of nerve tissue. The heat aims to stop that nerve from sending pain signals to the brain. Often the treated nerve is connected to a spinal joint that has been found to be the source of back pain.
A fluoroscope, which is an x-ray, is used to guide a needle to the pain area. A microelectrode is placed through the needle, and the radiofrequency current is delivered through it. Several nerves can be treated in one session.
How RFA and rhizotomy relate
Rhizotomy and radiofrequency ablation are closely related. Rhizotomy names the goal, which is to interrupt a pain nerve. RFA names the method, which uses radiofrequency heat. When the nerve being treated supplies a facet joint, the procedure is often called a facet rhizotomy. Our rhizotomy page focuses on facet joint pain in the neck and back. This page explains the technique and the other areas where RFA may be used.
Who may benefit
Who may be a candidate for radiofrequency ablation
RFA is most often used for long-lasting low back pain. It may also be used for pain in the neck, the sacroiliac (SI) joint and the knee, and for neuropathy.
RFA is most often not the first treatment for chronic pain. You may be a candidate if other treatments have not given enough relief. Usually you will first need a diagnostic procedure, such as a medial branch block, that gives good relief. This shows the right source of pain is being treated. Your provider may recommend less invasive treatments first.
What to expect
What to expect before, during and after RFA
Before your procedure
A diagnostic nerve block is usually done first to confirm the source of the pain. Your provider reviews your history and the results of your diagnostic block and explains the plan. Tell the team about your medicines and allergies, and ask how to prepare.
During the procedure
A physician places a needle with x-ray guidance, then delivers the radiofrequency current through a small electrode. The procedure often takes about 30 minutes to 2 hours, depending on the area and the number of nerves treated.
After your procedure
You go home the same day. You may notice a sunburn-like rash or irritation near the treated site. Ice packs and anti-inflammatory medicine can help until it eases. Many patients notice relief within a few days to a few weeks, but everyone is different. Your provider will review what to expect. A follow-up visit may be needed so the team can adjust your plan.
Benefits and limitations
How long the effect may last
Relief can last for months for some patients, but it varies. Nerves can grow back over time, so pain may return. If RFA helped you, it can be repeated. Your provider will review what to expect for your situation.
Risks and side effects
Risks and side effects of radiofrequency ablation
Most side effects are short-term and include soreness, bruising, swelling or skin irritation where the needle went in. Less often, there may be numbness, infection, a temporary rise in pain or nerve injury.
Please talk with your provider about the risks that apply to you before you decide.
Common questions
Questions about radiofrequency ablation
Your provider can talk through your own plan at your visit.
What is radiofrequency ablation and how does it work?
RFA uses heat from a radiofrequency current to quiet a nerve that is sending pain signals. A needle is guided to the nerve with x-ray imaging, and the current is delivered through a small electrode. It is closely related to rhizotomy.
Is radiofrequency ablation used for back pain?
Yes. RFA is most often used for long-lasting low back pain. Often the treated nerve is connected to a spinal joint that has been found to be the source of the pain, and a diagnostic block that gives good relief usually comes first. RFA may also be used for pain in the neck, the sacroiliac (SI) joint and the knee.
Who may be a candidate for radiofrequency ablation?
People with long-lasting pain who have not found relief with other treatments may be candidates. Usually a diagnostic nerve block that gives good relief comes first. Your provider will decide with you after reviewing your history.
How long does the procedure take, and is it painful?
RFA often takes about 30 minutes to 2 hours, depending on the area and the number of nerves treated. Your provider uses numbing medicine to keep you comfortable. Afterward you may notice a sunburn-like rash or irritation near the site.
What is recovery like, and when can I drive or go back to work?
You go home the same day. Ice packs and anti-inflammatory medicine can help with soreness or skin irritation. Your team will tell you when you can drive and return to work.
How long might the effect last?
Relief can last for months for some patients, but it varies with the person and the area treated. Your provider will review what to expect. If the effect fades, the procedure can be repeated.
Related care
Individual results are not guaranteed and may vary from person to person. This page shares general information. It is not medical advice and does not replace a visit with a qualified clinician.