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Treatments · Nerve Ablations

Radiofrequency ablation in Abilene, Texas

Targeted heat quiets the small sensory nerves that carry pain from arthritic spinal joints, the sacroiliac joint, the knee, and other peripheral nerves. We confirm the target with a diagnostic block first, so ablation is offered only to people it is likely to help.

Imaging

Live X-ray or ultrasound

Comfort

Local numbing with sedation

Time

About 20–40 minutes

Home

Same day

How it works

What it is, and why it works.

What it is · Controlled radiofrequency energy interrupts or calms overactive pain signals from specific nerves. These procedures target the source of pain in the face, neck, back, joints, or vertebral bones.

Why it's effective · By selectively disabling or modulating pain-carrying nerves, ablation reduces chronic pain, improves mobility, and helps patients return to normal activity with less reliance on medication. Relief can last from several months to over a year, and the procedure can be repeated safely if pain returns.

A specialized needle delivers radiofrequency waves that create a small heat lesion on the nerve carrying your pain. This mutes the nerve's ability to send pain signals to the brain without affecting normal touch or movement. The probe is positioned under live X-ray or high-resolution ultrasound and checked with precision testing before any energy is applied.

For facet joint pain in the neck or back, two sets of diagnostic medial branch blocks come first. Temporary relief from the blocks confirms the joints are the source and qualifies you for ablation. The same test-then-treat logic applies to the sacroiliac joint and to the genicular nerves of the knee.

Targets we treat

Medial branch (facet) ablation

For arthritic facet joints of the neck or low back confirmed by medial branch blocks. Relief typically lasts 6 to 18 months and the procedure can be repeated when the nerves regenerate.

Genicular, sacroiliac, and peripheral nerve ablation

For knee osteoarthritis pain, persistent pain after knee replacement, sacroiliac joint pain, and hypersensitized peripheral nerves after injury or surgery. Guided by ultrasound or X-ray.

Pulsed radiofrequency

Gentle, low-temperature energy that calms irritated or damaged nerves without destroying them. Used for neuropathic or post-surgical pain with minimal risk or downtime.

Basivertebral nerve ablation

A one-time treatment for chronic low back pain arising inside the vertebra, the deep, aching pain that shows on MRI as endplate changes and is often missed for years.

Who it helps

The conditions we most often treat this way.

Every plan starts with a diagnosis, not a procedure. Your first visit is an evaluation of your history, exam, and imaging, and we tell you what we believe is generating your pain before any treatment is scheduled. What the first visit is like →

Lumbar Spine & Low Back Pain

Facet joint and sacroiliac pain in the low back

Cervical, Neck & Upper Back Pain

Facet-mediated neck pain and whiplash

Joint & Extremity Pain

Knee arthritis and persistent pain after knee replacement

Head & Facial Pain

Occipital neuralgia and cervicogenic headache

Post-Surgical Pain

Surgical-site nerve pain and scar neuromas

What to expect

Before, on the day, and afterward.

Before

  • For spinal ablation, two sets of diagnostic medial branch blocks are required first, with a pain diary kept for the hours after each block.
  • Hold NSAIDs and aspirin for 24 hours; blood thinners have longer holds that our office will set with you.
  • If you are receiving sedation, nothing to eat or drink for six hours beforehand, and bring a driver.

Procedure day

  • The probe is positioned under live X-ray or ultrasound and its placement is confirmed with precision testing. Local numbing and sedation keep you comfortable.
  • The heat lesion itself takes only minutes; the whole visit is about 30 to 40 minutes and you go home shortly afterward.

Afterward

  • A deep, sunburn-like soreness over the treated area is normal for one to two weeks and can last up to six. Ice packs (20 minutes on, 20 off) help, and you may resume NSAIDs and aspirin immediately.
  • Activity and lifting as tolerated. Leave the dressing on for 24 hours; showering is fine. Some relief comes early, but the full benefit develops as the nerves settle over the following two to six weeks. We see you at four to six weeks to measure relief and function.

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

Call or text 325-326-3433. In an emergency, call 911.

Where it happens

Most of our image-guided procedures are performed in our own procedure suite at 1925 Hospital Place. When a case calls for a hospital or surgery center, we arrange it and remain your physicians throughout. Your appointment paperwork tells you which facility and when to arrive.

Full preparation and discharge details are in the handout below and in the general procedure guide (PDF).

The evidence

What the published data say.

All the evidence →

Medial branch blocks & facet RFA

Level I–II

Axial neck and low back pain from facet arthritis

When diagnostic medial branch blocks confirm facet-mediated pain, radiofrequency ablation of those nerves produces significantly greater pain and function improvement than sham or conservative care, typically lasting 6–18 months.

Nath S, et al. Percutaneous lumbar zygapophysial (facet) joint neurotomy using radiofrequency current, in the management of chronic low back pain: a randomized double-blind trial. Spine. 2008. · van Kleef M, et al. Spine. 1999.

For you · We confirm the joint is the culprit with a test block first — so ablation is only offered to people it is likely to help, and it can be repeated when pain returns.

Genicular nerve ablation

Level I

Knee osteoarthritis pain · persistent post-replacement knee pain

Randomized trials show radiofrequency ablation of the genicular nerves produces greater pain relief and function than intra-articular steroid injection at 6 and 12 months in knee osteoarthritis.

Davis T, et al. Prospective, multicenter, randomized, crossover clinical trial comparing the safety and effectiveness of cooled radiofrequency ablation with corticosteroid injection in the management of knee pain from osteoarthritis. Reg Anesth Pain Med. 2018. · Choi WJ, et al. Pain. 2011.

For you · If you are not ready for a knee replacement — or had one and still hurt — the nerves carrying that pain can be treated directly.

Basivertebral nerve ablation

Level I

Vertebrogenic low back pain with Modic changes

A sham-controlled and an active-comparator randomized trial both showed large, durable improvements in disability and pain for chronic low back pain arising from the vertebral endplates, sustained at 2 and 5 years.

Fischgrund JS, et al. Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: a prospective randomized double-blind sham-controlled multi-center study. Eur Spine J. 2018.

For you · A specific kind of deep, aching low back pain that shows on MRI as endplate changes — often missed for years — has its own targeted, one-time procedure.

Sacroiliac joint interventions

Level I

SI joint dysfunction · buttock and posterior pelvic pain

For confirmed SI joint pain, minimally invasive SI joint fusion outperformed non-surgical management in randomized trials; image-guided injections and lateral branch ablation serve both diagnostic and therapeutic roles.

Polly DW, et al. Randomized controlled trial of minimally invasive sacroiliac joint fusion using triangular titanium implants vs non-surgical management (INSITE): 12-month outcomes. Int J Spine Surg. 2016.

For you · Buttock pain misdiagnosed as “sciatica” for years is often the SI joint — and it has a defined treatment ladder.

Common questions

Answers before you call.

The blocks are the diagnosis. A medial branch block numbs the tiny nerves that carry pain from a facet joint; if your pain drops sharply for the hours the anesthetic is active, the joint is confirmed as the source and ablation is likely to help. Two positive sets are required before facet ablation is scheduled.

Your handout

The same guide we hand you in the office.

How to prepare, what happens on the day, and the discharge instructions for afterward. Download it, or send it to yourself to read at home.

Send it to yourself

Every handout is listed on the Your Procedure page.

Radiofrequency ablation — medial branchRead the guide →PDF ↓
Radiofrequency ablation — peripheral nerveRead the guide →PDF ↓
Medial branch block (the diagnostic step)Read the guide →PDF ↓

Ready to talk about your pain?

New patients are generally seen by referral. Ask your provider to fax records and imaging to 325-378-9175, or text us with a question first.

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