Radiofrequency neurotomy, also called radiofrequency ablation or lesioning, is a procedure that intentionally injures nerves to prevent pain signals from being sent to and processed by the brain. It is a minimally invasive surgical procedure reserved for those with chronic pain who have not found relief from more conservative treatment methods.
Radiofrequency treatments can be used on patients with pain from a degenerative disc, facet joint or sacroiliac (SI) joint. Guided by fluoroscopy, an electrode is inserted into the body and placed on the targeted nerve. Once positioned properly, the electrode is heated to create a lesion on the nerve. A more recent, advanced form of the procedure includes a cooling phase; this increases the area of the electrode’s impact and may be useful in certain locations of the body.
This treatment is not a permanent solution; over time, nerves heal and pain returns. It is important to remember that radiofrequency is a treatment that addresses the symptom of pain, not the initial cause thereof. Review the following pros and cons before deciding whether to receive this procedure.
Pros
For people who cannot perform day-to-day activities or work due to pain, a procedure like radiofrequency neurotomy can be tremendously positive. If effective, the procedure may allow people to return to work and perform basic daily activities like walking without excessive pain.
Results from radiofrequency treatment can last up to a year or two, which may make it more appealing than steroid injections, another common treatment for back and SI joint pain.
Neurotomy is a less invasive procedure than other surgical methods of eliminating joint and disc pain, particularly fusion surgery. Fusion creates a rigid segment between vertebrae or the pelvic bone and sacrum to inhibit painful motion from instability. The procedure comes with a high price tag and a host of risks, including accelerated degeneration of facet joints and spinal discs near the fused joint. Radiofrequency lesioning may provide enough pain relief to avoid more invasive surgery.
Research indicates that this procedure is helpful to some degree for around 70% of those who receive it and that it may decrease reliance on expensive and dangerous pain medications. See http://www.prnewswire.com/news-releases/studies-published-in-pain-medicine-demonstrate-effectiveness-of-minimally-invasive-cooled-radiofrequency-treatment-for-low-back-pain-194185701.html for a collection of research supporting the use of cooled radiofrequency for discogenic and SI joint pain.
Cons
Radiofrequency lesioning makes pain worse before making it better. The initial week following the procedure can be difficult due to local soreness and swelling. Some patients who have received the treatment report that it can take a month or two to feel any positive effects.
Some patients receiving the treatment never experience relief. Some may even experience more pain if the procedure was done incorrectly and the targeted nerve was incompletely damaged; this would cause it to increase its pain signal output. See http://www.spine-health.com/forum/treatment/pain-management/rf-neurotomy-ablation-has-worked-you-how-long-did-it-take-notice-res to read reviews of the procedure from a number of people who have received it.
It must be remembered that this treatment is not a cure; it just masks the pain. Whether your pain is caused by a degenerated disc, facet joint or SI joint, it is important to continue efforts to resolve the underlying issue. Research alternative medicine to find treatment options you may not be aware of. Take advantage of your pain-free or reduced pain time post-radiofrequency treatment to follow through on exercise therapy, strengthening your core muscles that support joints and spinal discs.
Radiofrequency neurotomy may be a suitable treatment for you if pain is interfering with your quality of life. The focus of any chronic pain treatment plan, however, should be to address the cause of pain and not just mask the symptom.