Radiofrequency Ablation

Radiofrequency ablation uses a specialized needle to apply carefully controlled thermal energy to the medial branch nerves that carry pain signals from the facet joints. The goal is to interrupt those specific pain signals for a period of relief that typically lasts substantially longer than diagnostic blocks.

This procedure is considered only after diagnostic medial branch blocks have demonstrated that the facet joints are a genuine pain source. That sequencing matters: ablation applied to unconfirmed joints treats a guess, while ablation applied to confirmed joints addresses a demonstrated pain generator.

Appropriate for patients whose diagnostic blocks confirmed the facet joints as a significant pain source, whose pain persists and limits activity despite conservative care, and for whom the expected duration of benefit makes the procedure worthwhile. It is not performed on unconfirmed facet joints, and candidacy includes a frank discussion of expected duration of relief.

Most people go home the same day. The treated area is often sore for one to two weeks, occasionally with a burning quality as the targeted nerves respond, and this typically settles. Normal activities generally resume within a few days, with specific guidance provided. The meaningful assessment point is several weeks out, once post-procedure soreness has resolved, since the full effect develops over that period.

Common considerations include post-procedure soreness and temporary neuritis, a briefly increased burning sensation around the treated area. Uncommon risks include bleeding, infection, temporary numbness, and rare nerve injury. The sensory testing performed before ablation is specifically designed to protect motor nerves. Incomplete relief, or benefit that fades sooner than expected, is a possible outcome.