Radiofrequency ablation (RFA), also known as nerve ablation, involves heating nerve tissue to damage or destroy nerves that carry pain signals. When RFA is used to target specific nerves in the lower back, the lumbar region, it’s called lumbar radiofrequency ablation.

Lumbar RFA  disrupts nerves that transmit pain signals from the facet joints, which are points of contact between the vertebrae that make up the spinal column.

During RFA, the doctor uses real-time X-ray “video” to guide a needle toward the problem nerve. The needle delivers radio waves that create a heat lesion in the nerve tissue. The treatment is less invasive than open surgery and can provide long-term relief from back pain, which affects millions of people.

Patients usually can return to their normal routines quickly, with fewer complications than might occur with more invasive, surgical options like spinal fusion or disc replacement.

Conditions that lumbar RFA helps treat

Lumbar RFA is a form of interventional pain treatment that can address a wide range of conditions  without the need for major surgery.

• Chronic facet arthropathy. RFA targets the medial branch nerves that transmit pain from damaged facet joints. Interrupting the pain signals provides significant relief without having to alter the joint structure itself.
• Lumbar spondylosis. This condition, also known as osteoarthritis of the spine, is age-related deterioration of the vertebrae and related tissues. Lumbar RFA may alleviate inflammation-driven pain and restore mobility by blocking pain signals traveling through the affected spinal nerves in these damaged locations.
• Persistent lower back pain not responsive to other treatments. In cases when injections, medicine, and physical therapy don’t alleviate nerve-related pain, RFA provides a minimally invasive alternative.

What to expect before, during, and after

Understanding how the lumbar RFA procedure works can help you make more informed decisions about your care. You’ll know what to expect, so you don’t feel confused or caught off guard.

Pre-procedure medial branch block

Before performing RFAs , medial branch blocks are used to help determine the source of the back pain. Using X-ray guidance, the physician inserts a thin needle near the targeted nerves and injects a small amount of local anesthetic. If there is a noticeable decrease in pain, it indicates that an RFA procedure is probably going to help.

Procedure and recovery time for lumbar RFA

The lumbar RFA procedure  normally takes about 15 minutes to 1 hour. Patients requiring treatment at multiple locations take the most time.

You lie on your stomach and local anesthesia is used to numb a spot on your back. The physician guides a thin, hollow needle to the appropriate spot on the nerve and then delivers a radiofrequency current to deaden the nerve.

You can return home shortly after this outpatient treatment, but you’ll need someone to drive. Doctors generally recommend avoiding driving and any strenuous activity for 24 hours.

Post-procedure care tends to be simple. If you feel soreness, pain or muscle spasms your doctor may recommend application of ice packs for the first day. You might also receive a prescription for pain medicine. Any discomfort from the procedure usually fades away within a week or two.

Typical relief window

Relief from chronic back pain may occur immediately or within 10 days, although for some people it could come within three weeks.

Most patients experience pain relief for 6 to 12 months after a lumbar RFA procedure, with some reporting relief for much longer. The relief may be complete or limited. However, the procedure can be repeated, if necessary for long-term pain management.

Who is a good candidate for lumbar radiofrequency ablation?

Not everyone is an ideal candidate for a lumbar RFA. Those with spinal instability or severe spinal stenosis tend to benefit more from surgical options, like spinal fusion or laminectomy. For the right candidates, though, lumbar RFA can offer a safe, effective path to long-term pain relief.

Patients with positive response to diagnostic injections

For lumbar RFA to be successful, a favorable reaction to medial branch blocks is crucial. If the injection alleviates the pain for a short period of time, it means that the injection was successful in reaching the painful nerves. The medial branch block is considered mainly as a diagnostic procedure and the RFA as a therapeutic procedure.

When conservative treatments haven’t provided lasting relief

If you’ve tried other treatments like physical therapy or anti-inflammatory medications and they don’t provide lasting relief, a lumbar RFA may offer the targeted pain relief you need. Your doctor will carefully review your medical history and perform diagnostic tests to determine if RFA is the right option. These tests may include MRI scans, X-rays, CT scans, and nerve blocks.

Benefits and considerations

Let’s break down why this treatment works:

• Long-term pain relief without surgery. Lumbar RFA disrupts pain signals at the nerve endings before they reach the brain. This outpatient procedure could provide non-invasive, long-term relief for 6 to 12 months, or potentially longer.
• Low risk of complications. The risks of infection, bleeding, and nerve damage are quite low with lumbar RFA since the therapy is minimally invasive.
• Decreased need for pain medication.
• Not a cure—part of a comprehensive pain management plan. Even though lumbar RFA works well on its own, it is most effective when used in conjunction with other therapies, such as physical therapy and lifestyle modifications.

Expert guidance on lumbar radiofrequency ablation

Lower back pain can be excruciating and limit your daily functioning. Many people also experience emotional distress as they try to cope with the ongoing discomfort. If pain medications and physical therapy are not helping, you could still avoid surgery. A lumbar RFA is an excellent non-surgical solution for qualified candidates.

You can discuss this treatment option with a doctor at Florida Medical Clinic Orlando Health. Our Interventional Pain Management Department offers a range of treatment options for chronic spine-related pain, like spinal cord stimulation, intradiscal treatment, epidural injection , and lumbar RFA. We take the hassle out of pain management by giving you access to advanced, minimally invasive treatments delivered by experienced specialists.

About Dr. Temperato

Dr. Kathy Temperato has advanced training in the subspecialties of sports musculoskeletal medicine and interventional spine medicine. She tailors her approach to treating back pain to each individual’s way of life and their specific objectives by using a holistic, patient-centered approach.

Her expertise includes managing spinal conditions such as disc degeneration and nerve compression. When conventional pain treatments fail, she can provide patients with cutting-edge procedures like lumbar RFA performed under fluoroscopic guidance to alleviate back pain without the need for surgery.

Request an appointment online or call 813-977-6688.