Learning About Lumbar Radiofrequency Ablation

Lumbar radiofrequency ablation is a way to treat long-term (chronic) pain in your lower back (called the lumbar area). Chronic low back pain is often caused by arthritis or other problems with the facet joints between the bones (vertebrae) in your spine. If the facet joints become inflamed or hurt, it can cause pain and stiffness. You may even feel the pain down in your buttocks, groin, hips, or thighs.

Radiofrequency ablation uses radio waves to create heat and destroy the nerves around the joints that are causing pain. That means the nerves can no longer send pain signals to your brain.

Before a lumbar radiofrequency ablation, your doctor will do a test called a nerve block to find out if facet joints are causing your pain. The block uses medicine to numb the nerves around the joints and block the pain signal. If your pain gets better, that means problems with the facet joints might be the cause.

The medicine from a nerve block usually wears off after a few hours or days. When that happens, your pain returns. Radiofrequency ablation can stop your pain for longer.

Before the procedure, make sure to:

• Tell your doctor about any medicines or supplements you take. This is especially important if you take blood thinners, since those medicines could cause problems during the procedure.
• Let your doctor know if you might be pregnant.
• Follow any directions your doctor may give you for not eating or drinking before the procedure.

You might get a sedative through a needle into your arm (medicine to help you relax). Then you’ll lie on an exam table on your belly. Your doctor or nurse will clean your skin with an antiseptic and numb it.

To find the right spot to place the needle, your doctor will use fluoroscopy (a type of X-ray) to help guide them. Once the needle is in place, your doctor will do a test to make sure they’ve found the right nerve. They will stimulate the nerve with a small electric current. If you feel a tingling sensation, twitching, or pain, it means they've found the right nerve.

Next, your doctor will inject medicine through the needle to numb the nerve. Then they'll send a radiofrequency current to create heat and destroy the nerve. If needed, your doctor will repeat the same process with other nerves around your spine.

You’ll be able to go home after about an hour. You’ll need someone to drive you home from the hospital. But you will probably be able to resume your normal activities the next day.

You may have soreness, pain, or muscle spasms in your back for a few days. Talk with your doctor about medicines to help with the pain. Applying ice to the area can also help. It may take up to a week or two until your pain gets better.

Pain relief can last for several months. Some people even feel pain relief for a few years.

The nerve may regrow and start sending pain signals again. If that happens, you may be able to have another radiofrequency ablation.

The most common side effect is bruising or pain where the needle went into your skin. This usually goes away within a few days.

Serious problems are rare, but they can happen. These include:

• Infection or bleeding.
• Nerve damage.
• An allergic reaction to a medicine.

Contact your doctor right away if you have:

• Symptoms of an infection, like fever, chills, or severe swelling and redness at the injection site.
• Severe pain.
• Numbness or weakness that’s getting worse.