What is Radiofrequency neurotomy?
Radiofrequency neurotomy (RF neurotomy), also known as radiofrequency ablation (RFA), is a medical procedure used to treat chronic pain, particularly in musculoskeletal disorders. The goal of RF neurotomy is to reduce or eliminate pain by disrupting the function of specific nerves that are transmitting pain signals.
How It Works:
RF neurotomy uses heat generated by radio waves to target and "ablate" (destroy) the nerve fibers that carry pain signals from the affected joints, muscles, or tissues. A needle-like probe is guided to the precise location of the nerve using imaging techniques like fluoroscopy (X-ray guidance), and once in place, radiofrequency energy is delivered to generate controlled heat. This heat damages the nerve, preventing it from sending pain signals.
Common Applications in Musculoskeletal Disorders:
Facet Joint Pain
(Cervical, Thoracic, Lumbar): One of the most common uses of RF neurotomy is for facet joint pain in the spine. The facet joints are small joints that provide stability and flexibility to the spine. In conditions such as arthritis or injury, these joints can become inflamed and painful.
Sacroiliac Joint Dysfunction:
RF neurotomy is used for patients with chronic pain in the sacroiliac joint (where the spine meets the pelvis), which can result from inflammation or degeneration.
Knee Osteoarthritis:
For patients with severe osteoarthritis of the knee who may not be candidates for surgery, RF neurotomy can be used to target the sensory nerves around the knee, reducing pain.
Hip Joint Pain:
RF ablation can also be applied to chronic pain in the hip joint, particularly in cases of osteoarthritis.
Peripheral Nerve Pain:
In cases of chronic pain in other areas, such as the shoulder, RF neurotomy can target peripheral nerves responsible for transmitting pain signals.
Procedure Steps:
Preparation: The patient is typically awake but sedated, and local anesthetic is applied to the area.
Needle Insertion: A thin probe is inserted through the skin using imaging (fluoroscopy or ultrasound) to guide it to the appropriate nerve.
Stimulation: The physician may use a small electrical current to ensure the probe is near the nerve that causes the pain.
Ablation: Once in the correct position, radiofrequency energy is applied to heat and ablate the nerve.
Expected Benefits:
Pain relief can last for several months to over a year, depending on the individual.
Improvement in mobility and daily function, especially for conditions like arthritis.
Reduced need for pain medications, including opioids.
Risks and Side Effects:
Temporary numbness, discomfort, or soreness at the injection site.
Risk of infection or bleeding.
Rarely, nerve damage or prolonged numbness.
Pain may return as nerves regenerate, requiring repeat treatments.
Effectiveness:
RF neurotomy has shown good success in many patients, particularly for conditions like facet joint pain and sacroiliac joint dysfunction. However, the outcomes can vary based on the condition being treated and individual patient factors.
This procedure can be a valuable option for managing chronic musculoskeletal pain, especially when conservative treatments (physical therapy, medications, etc.) have failed.
If you think this could be the right treatment pathway for you come and see your friendly physiotherapist at Brisbane physiotherapy to get the information and referrals you need to progress with your treament.
