In brief
- Peripheral nerve RFA offers a durable solution for patients who found temporary relief from diagnostic nerve blocks.
- Relief often lasts 6 to 18 months.
- Most patients return to regular, light activity the next day.
- Full benefits typically develop over 4 to 6 weeks as the nerves settle.
Understanding your diagnosis
Chronic pain can often be traced to hypersensitized peripheral nerves, those located outside the brain and spinal cord. When these nerves transmit persistent pain signals due to injury, surgery, or chronic inflammation, radiofrequency ablation (RFA) offers a durable solution for patients who previously found temporary relief from diagnostic nerve blocks.
The treatment
Peripheral nerve RFA is a minimally invasive procedure that uses thermal energy to interrupt pain signaling. Dr. Pugh uses a specialized probe to deliver radiofrequency waves, creating a small heat lesion on the targeted nerve. This effectively mutes the nerve's ability to send pain signals to the brain, providing long-term relief without invasive surgery.
Our approach
Dr. Pugh uses high-resolution ultrasound or live X-ray (fluoroscopy) to visualize the anatomy in real time, so the RFA probe is positioned with sub-millimeter accuracy.
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 using real-time imaging for exact safety and positioning.
- Local numbing and light sedation are used to ensure a comfortable experience.
- The procedure typically lasts between 20 and 40 minutes.
- Outpatient procedure: you will be able to return home the same day.
Benefits
- Durable relief: often provides significant pain reduction lasting 6 to 18 months.
- Improved mobility: designed to help you return to your hobbies and daily activities.
- Non-surgical option: a proven alternative for chronic nerve pain in the knees, shoulders, or extremities.
Recovery
- Activity: most patients return to regular, light activity the next day.
- Soreness: you may feel mild localized tenderness or sunburn-like soreness for a few days.
- Results timeline: full benefits typically develop over 4 to 6 weeks as the nerves settle.
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 peripheral nerve ablation (radiofrequency ablation), a specialized procedure designed to provide long-term relief from chronic nerve pain located outside your brain and spinal cord. Following your diagnostic blocks, we have used thermal energy to create a small heat lesion on the targeted peripheral nerves. This effectively mutes the nerves' ability to transmit persistent pain signals from the affected area to your brain.
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.