Radiofrequency treatment

Radiofrequency treatment is a technique that uses high-frequency electric current to produce heat or pulses in specific nerves or tissues. The aim is to reduce or block the transmission of pain signals from these areas.

Electrodes (resembling long needles) are inserted into the body under local anaesthesia, and positioned precisely beside the area to be treated (for example adjacent to the spine, or a nerve in the arm or leg). An electrical current is then passed through the electrode.

• Thermal radiofrequency treatment creates a small lesion or burn in the target nerve or tissue, which interrupts the pain signals. This is done by applying a continuous electric current through a needle electrode inserted near the nerve or tissue. The temperature of the electrode is usually between 60°C and 85°C, and the lesion is about 5 mm in diameter.
• Pulsed radiofrequency treatment delivers short bursts of electric current through a needle electrode inserted near the nerve or tissue. The temperature of the electrode is usually below 42°C, and no lesion or burn is created. Pulsed radiofrequency treatment is thought to alter the function of the nerve or tissue by changing the expression of certain proteins and genes involved in pain transmission.

Examples of conditions we treat include:

• Neck pain, including whiplash
• Certain forms of cervicogenic headache
• Low back pain
• Sacroiliac joint pain
• Morton’s neuromas
• Neuropathic pain: Pain arising from damage to nerves throughout the body

To determine if your condition is suitable for treatment with radiofrequency, tests may be required, such as diagnostic injections.

Radiofrequency treatment can provide long-lasting pain relief for patients who have not responded well to other treatments, reduce the need for pain medications, improve the quality of life and function, and avoid the need for surgery.

Radiofrequency treatment is generally safe and well-tolerated, but some possible risks and complications include:

• Bleeding, infection, or bruising at the needle insertion site
• Nerve damage, which may cause numbness, tingling, weakness, or increased pain in the treated area or nearby regions
• Allergic reaction to the local anaesthetic or contrast dye used during the procedure
• Thermal injury to the surrounding tissues or organs
• Failure to achieve pain relief or recurrence of pain after a period of time

Radiofrequency treatment is performed in an outpatient setting, under local anaesthesia.

An X-ray machine or an ultrasound device is used to locate the target nerve or tissue. A needle electrode is inserted through the skin.

Once the electrode is in the right position, the provider will deliver the radiofrequency current, either continuously or in pulses, depending on the type of treatment. You may feel some warmth or pressure in the area, but you should not feel any severe pain. The provider may repeat the procedure for other nerves or tissues, if needed.

The whole procedure may take 30 to 90 minutes, depending on the number and location of the nerves or tissues treated. You will need someone to drive you home and stay with you for the first 24 hours.

You may have some soreness, swelling, or bruising at the needle insertion site, which should improve within a few days. You may also have some temporary numbness, tingling, or weakness in the treated area or nearby regions, which should resolve within a few weeks. You may apply ice packs or take over-the-counter pain medications to ease the discomfort.

You may notice some improvement in your pain within a few days or weeks after the procedure, but the full effect may take up to three months. The duration of pain relief varies from person to person, depending on the type and severity of the condition, the response to the treatment, and the occurrence of any complications. Some people may need repeat procedures to maintain the pain relief.

You should avoid any strenuous or heavy activities for the first week after the procedure. You should avoid soaking the needle insertion site in water for the first 48 hours.