Radiofrequency Ablation for Lower Back Pain, Knee Pain and Headaches
Radiofrequency ablation is a type of back pain treatment where, under live X-ray, we use a small needle on the area between the transverse process and the superior articular process known as the medical branch. The medical branch innervates two things: a very small muscle called the multifidus and the sensory where it feels sensation or pain from the facet joint. We hook the small, insulated needle up to a machine, which speeds up radio waves until it gets hot. When the tip of the needle heats up, we burn the nerve to provide back pain relief.
First off, we need to talk to you, evaluate your history and do a physical exam to determine whether or not you fit with the diagnosis of facet mediated pain. If you fit the diagnosis, you’ll go to the procedure room where we use a small needle and inject local anesthetic near the medical branch. If your lower back pain is reduced for a temporary amount of time, we do the back pain treatment a second time to make sure your pain improves. Then we schedule the radiofrequency ablation procedure.
We start an I.V. and use a little medicine and make you sleepy. Then we place three or four special needles in the nerve of your back and burn it. You wake up from anesthesia 6-10 minutes later. Unlike other procedures, you will still be sore for two to three days. You aren’t going to notice much back pain relief for about two to three weeks.
There are actually three or four other locations in the body where we can do this type of back pain treatment for chronic spine pain. One is a procedure I love to do because patients do so well afterwards. It’s a back pain treatment for third occipital neuralgia, which is basically a headache caused by upper spine pain radiating across the back of the skull, called the occiput, into the side of the head, called the temporal region, and sometimes into the eye.
The procedure is the same as the one done to treat lower back pain. We do a test where we inject local anesthesia in the occipital nerve. If you get better after two attempts, we do radiofrequency ablation.
Radiofrequency can also be used for knee pain relief. We do the same radiofrequency procedure to three of the six nerves that innervate the knee. I place that needle around those three nerves in your knee and we radiofrequency the lesion around the nerve. Again, it takes a few weeks to experience complete knee pain relief.