RadioFrequncy

Radiofrequency Treatment is a procedure using a specialized machine to interrupt nerve conduction on a semi-permanent basis. The nerves are usually blocked for a period as short as 3 months or as long as 18 months if not even permanently.

Under CT or X-ray control, a probe is attached to the middle, posterior nerve branch of the spinal nerve. The painful structure is heated up and the nerve trunk gets coagulated. Therefor the pain pathway is interrupted immideately. The probe can also be attached to the joint capsule of the facet joints and coagulate the pain receptors of the joint capsule.

radiofrequency

The surgery is an outpatient procedure, performed under local anesthetics and takes about 20 minutes. Complications are virtually eliminated, side effects are rare and temporary.

Am I a candidate for Radiofrequency Treatment?

Currently, Radiofrequency Treatment is offered to patients with:

  • Headache, especially pain arising from the back of the head. ("cervicogenic headache")
  • Neck pain, following injury and automobile accidents
  • Back pain, following injury and automobile accidents
  • Mechanical neck or low back pain due to facet joint disease
  • Occipital neuralgia

You must have responded well to diagnostic blocks to be a candidate for Radiofrequency Treatment.

What are the benefits of Radiofrequency Treatment? The procedure disrupts nerve conduction (such as conduction of pain signals), and it may in turn reduce pain and other related symptoms. Approximately 70-80% of patients will get good block of the intended nerve. This should help relieve that part of the pain that the blocked nerve controls. Sometimes after a nerve is blocked, it becomes clear that there is pain from the other areas as well.

What happens during the procedure? The procedure is done as an outpatient at our surgical suite under fluoroscopy (X-ray guidance). Depending upon the areas to be treated, the procedure can take from about 20 minutes to an hour. Since the nerves cannot be seen on x-ray, the needles are positioned using bony landmarks that indicate where the nerves usually are. Fluoroscopy is used to identify those bony landmarks. The skin on the back is cleaned with antiseptic solution. A local anesthetic (like Novocain) is injected to numb the skin. A special cannula is advanced under x-ray to the area of the nerve. When the needle is in good position, as confirmed by x-ray, electrical stimulation is done before any treatment. This stimulation may produce a buzzing or tingling sensation or may be like hitting your "funny bone". You may also feel your muscles jump. You need to be awake during this part of the procedure so you can report what you are feeling. The tissues surrounding the needle tip are then heated when current is passed using the Radiofrequency machine. This "numbs" the nerves semi-permanently.

Will the procedure hurt? Nerves are protected by layers of muscle and soft tissues. The procedure involves inserting a needle through the skin and those layers of muscle and soft tissues, so there is some discomfort involved. However, we numb the skin and deeper tissues with a local anesthetic using a very thin needle prior to inserting the Radiofrequency needle. You will also be sedated for the procedure. You will be awake, but usually very comfortable during the procedure. On occasion we will need to interact with you.

What should I expect after the procedure? You are required to have a driver remain at Midwest Pain Treatment Center during the procedure and drive you home after the procedure. We advise the patients to take it easy for a day or so after the procedure. You may want to apply ice to the affected area. Perform the activities as tolerated. Initially there will be muscle soreness for up to a week afterward. Ice packs will usually control this discomfort. After the first week is over, your pain may be gone or markedly reduced. If successful, the effects of the procedure can last from 3-18 months, usually 6-9 months. It is very difficult to predict if the procedure will indeed help you or not. Generally speaking, the patients who have previously responded to repeated facet blocks with local anesthetic will have better results. If the first procedure does not relieve your symptoms completely, you may be recommended to have a repeat procedure after re-evaluation. Usually they do not need to be repeated more than twice.

Can I go to work the next day? You should be able to return to work the next day. Sometimes soreness at the injection site cause you to be off work for a day or two.

What are the risks and side effects? Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects, and the possibility of complications. The risks and complications are dependent upon the sites that are lesioned. Any time there is an injection through the skin, there is a risk of infection. This is why sterile conditions are used for these blocks. The needles go through skin and soft tissues, which will cause soreness. The nerves to be lesioned may be near blood vessels or other nerves which can be potentially damaged. Great care is taken when placing the radiofrequency needles, but sometimes complications occur. Please discuss your specific concerns with you physician.

How should I prepare for the procedure? Unless otherwise instructed, you should not eat or drink anything 8 hours before the procedure. You should stop taking any blood thinners like Coumadin, at least five days before the procedure. You can take all of your other medications except oral diabetic meds with a sip of water the morning of the procedure. Diabetics, please discuss with your physician regarding your other diabetic medications.

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