In brief
- Radiofrequency ablation often provides significant pain reduction for 6 to 18 months, and can safely be repeated if pain returns.
- Hold NSAIDs and aspirin for 24 hours; blood thinners have longer holds.
- A deep, sunburn-like soreness for one to two weeks is normal and can last up to six.
- Peak benefit typically develops between four and six weeks as the nerves settle.
Understanding your diagnosis
Following your successful medial branch blocks, we have confirmed that your pain originates from the facet joints. While the blocks were a diagnostic test, radiofrequency ablation (RFA) is the therapeutic solution designed to provide lasting relief from chronic neck or back pain caused by arthritis or joint degeneration.
The treatment
RFA is a minimally invasive procedure that uses thermal energy to interrupt pain signals. Using a specialized needle, Dr. Pugh delivers radiofrequency waves to create a small heat lesion on the medial branch nerves. This effectively mutes the pain signals traveling from the arthritic joints to your brain, providing relief without the need for major surgery.
Our approach
We use live X-ray (fluoroscopy) and precision testing to ensure the RFA probe is positioned with sub-millimeter accuracy. This evidence-based approach is designed to restore your mobility and reduce your reliance on oral medications.
Before your procedure
For your safety, certain medications must be held before your procedure to minimize the risk of bleeding, following American Society of Regional Anesthesia guidelines. This procedure requires the 24-hour NSAID hold.
| Medication type | Examples | Required hold |
|---|---|---|
| NSAIDs | Ibuprofen, Motrin, Aleve, naproxen, meloxicam | 24 hours |
| Salicylates | Aspirin, all doses | 24 hours |
| Antiplatelets | Plavix (clopidogrel), Brilinta | 7 days |
| Antiplatelets | Effient (prasugrel) | 10 days |
| Anticoagulants | Eliquis, Xarelto, Savaysa, Pradaxa | 5 days |
| Vitamin K antagonist | Coumadin, warfarin | 5 days (INR below 1.5) |
Restarting
Most medications can be restarted 24 hours after the procedure. NSAIDs and aspirin may be resumed immediately.
Fasting, sedation, and your ride home
- If you are receiving sedation, nothing to eat or drink for six hours before your appointment. Essential morning medications may be taken with a small sip of water only.
- We offer light or deep sedation. The level is decided by the physician and anesthesia team based on the procedure and clinical need.
- Any patient receiving sedation must be accompanied by a responsible adult driver to take them home.
Where to go
Procedures are performed at one of three facilities: our clinic at 1925 Hospital Place, ACOM at 6449 Central Park Blvd, or Hendrick South at 6399 Directors Pkwy, Suite 100. Your appointment paperwork tells you which one. Please arrive early for registration and pre-procedure preparation.
Procedure day
- Performed under live X-ray (fluoroscopy) for maximum precision.
- We use sedation and local numbing medication to ensure a comfortable experience.
- The entire procedure typically lasts about 30 to 40 minutes.
- Patients return home shortly after the treatment is complete.
Benefits
- Durable relief: often provides significant pain reduction for 6 to 18 months.
- Enhanced mobility: helps you return to the activities and hobbies you enjoy.
- Proven alternative: an effective non-surgical option for chronic spinal joint pain.
Recovery
- Short-term soreness: you may feel mild localized tenderness for a few days following the procedure.
- Results timeline: while some relief is immediate, full benefits typically develop over 2 to 4 weeks.
- Long-term care: if nerves eventually regenerate and pain returns, the procedure can safely be repeated.
Afterward: what to expect
- The sunburn flare. It is normal to feel a deep, localized soreness or a sunburn sensation in the treated area for 1 to 2 weeks; it can last up to 6 weeks.
- Management. Use ice packs (20 minutes on, 20 off) and resume baseline medications, including NSAIDs and aspirin, immediately.
- Results. While some relief may occur sooner, peak benefits typically develop between 4 and 6 weeks as the nerves settle.
Activity
Wound care
Your procedure in one paragraph
You have undergone a radiofrequency ablation (RFA), a specialized procedure designed to provide long-term relief from chronic back or neck pain originating from the facet joints. Following your successful diagnostic blocks, we have used thermal energy to create a small heat lesion on the medial branch nerves. This stuns the nerves' ability to transmit pain signals from the joints to your brain, without affecting your ability to feel normal touch or movement.
Follow-up schedule
- 1
4 to 6 weeks
Formal functional assessment of how well the ablation worked.
Call us right away if you notice
- New or worsening leg weakness, numbness, or foot drop
- Sudden loss of bowel or bladder control
- Fever above 101.5°F, chills, or drainage at the site
- A severe headache that worsens when sitting or standing
This guide is the same information as the printed handout from Abilene Pain. It is general information and does not replace the instructions your care team gives you at your visit. Your care team: Nicolas Pugh, MD · Adrianne Anders, NP · Ted Chaka, PA.