Radiofrequency neurotomy

Overview

Radiofrequency neurotomy uses heat created by radio waves to target specific nerves. The treatment turns off the nerves' ability to send pain signals for a short time. The procedure also is known as radiofrequency ablation.

Needles inserted through the skin near the painful area deliver the radio waves to the targeted nerves. A doctor typically uses imaging scans during radiofrequency neurotomy to make sure the needles are positioned properly.

Radiofrequency neurotomy often is used for pain in the back, neck and butt. The treatment also may be helpful for long-term shoulder, knee or hip joint pain.

Why it's done

Radiofrequency neurotomy is usually done by a provider who specializes in treating pain. The goal is to reduce chronic back, neck, hip or knee pain that hasn't improved with medications or physical therapy, or when surgery isn't an option.

For example, your provider may suggest the procedure if you have back pain that:

• Occurs on one or both sides of your lower back
• Spreads to the buttocks and thighs (but not below the knee)
• Feels worse if you twist or lift something
• Feels better when you're lying down

Radiofrequency neurotomy might also be recommended to treat neck pain associated with whiplash.

Risks

Common side effects of radiofrequency neurotomy include:

• Temporary numbness.
• Temporary pain at the procedure site.

Rarely, more-serious complications may occur, including:

• Bleeding.
• Infection.
• Nerve damage.

How you prepare

To learn if you're a good candidate for radiofrequency neurotomy, you may be referred to a pain specialist or for more tests.

For example, a test may be done to see if the nerves commonly targeted by the procedure are the same nerves responsible for your pain. A small amount of numbing medicine is injected into the precise spots where the radiofrequency needles go. If your pain lessens, radiofrequency treatment at those spots may help you.

However, a different procedure may be needed to help your specific symptoms.

What you can expect

Before radiofrequency neurotomy

Let your doctor know if you take blood-thinning medicines. You may need to stop taking them for a period of time before the procedure.

Follow these steps:

• Arrange for someone to drive you home.
• Swallow any necessary medicines with clear liquids only and take them as early in the day as possible. Don't take medicines within two hours of your procedure.
• Don't smoke or use any tobacco products the day of your procedure.

During radiofrequency neurotomy

Radiofrequency neurotomy is an outpatient procedure, so you'll go home later that same day.

You wear a hospital gown and lie on an X-ray table. An intravenous (IV) line is placed in your arm or hand to deliver medicine that keeps you comfortable during the procedure. Numbing medicine is injected into your skin before the radiofrequency needles are inserted.

A special X-ray machine called a fluoroscope guides the radiofrequency needles to the precise area. This ensures that only the targeted nerve tissue is treated.

After radiofrequency neurotomy

You'll be taken to another room to rest until you feel ready to go home. You might notice some soreness in the area where the needles were inserted, but this usually goes away in a day or two.

When you get home:

• Use an ice pack on the injection sites if you have discomfort. Place the pack on the sore spots for 20 minutes, three or four times a day, during the first day of your recovery.
• Don't use a heating pad on the injection sites.
• Don't take baths for two days. You may take a warm shower 24 hours after your procedure.

Results

Radiofrequency neurotomy isn't a permanent fix for back or neck pain.

Studies on the success of treatment have been conflicting. Some people may have modest, short-term pain relief, while others might feel better for several months. Sometimes, the treatment does not improve pain or function at all.

For the treatment to work, the nerves targeted by the procedure need to be the same nerves responsible for your pain.