Lumbar Radiofrequency Ablation (RFA)

Lumbar Radiofrequency Ablation (RFA)

Lumbar Radiofrequency Ablation (RFA), also known as radiofrequenc neurotomy, is a minimally invasive procedure that treats pain coming from the joints in the back (facet joints)of the lumbar spine.

What is RFA?

Radiofrequency ablation is an outpatient procedure that uses a special needle to heat and desensitize nerves that transmit pain signals. This results in long-lasting pain relief, between nine to 12 months in 90% of patients. To know if you’re a good candidate for an RFA, a diagnostic block must first be performed using a local anesthetic to identify the pain generator. Positive diagnostic blocks show 80 to 100 percent relief of pain for the first eight to 12 hours.

RFA is a treatment option for neck pain, low back pain, sacral/hip/buttock pain, knee pain, and occipital neuralgia.

This procedure uses heat from radio waves to treat painful facet joints in your neck. It eases pain that isn't helped by medications or physical therapy.

This procedure uses heat from radio waves to treat painful facet joints in your lower back. It eases pain that isn't helped by medications or physical therapy.

What to expect afterwards?

Your doctor and staff will explain what to expect before, during, and after the treatment. If you want sedation for your procedure please inform us beforehand.  We ask that you have a responsible adult drive you home. Most patients prefer to do the procedure awake under local anesthesia. You may need to stop taking certain medicines (blood thinners) several days before your procedure. If you have an infection, please inform your physician as your procedure may have to be rescheduled.

All our procedures are performed in a sterile manner using image guidance. You will first be comfortably positioned on your stomach. After a sterile cleaning of the site to be treated, sedation will be given if desired. Then local anesthesia will be used to numb the skin. The needle will be placed using image guidance. Once the procedure is finished, needles are removed, and bandages will be placed. You will be taken to the recovery room until you are ready for discharge home.

How long does an RFA Last?

RFA uses heat to desensitize the nerve. It leaves the outer architecture of the nerve intact while causing the proteins inside the nerve to degrade. As the nerve regenerates itself over 6-12 months, the pain may return and the RFA can be repeated.  RFA is a covered procedure by all insurance including Medicare.

What are the risks?

Risks of an RFA include bleeding, infection, nerve injury and neuroma formation when the nerve regrows. These risks are reported to be 1-2%. In addition, some patients may have increased sensitivity which may feel like a sunburn over the treated site for up to 3-4 weeks after the procedure. We usually recommend placing an icepack over the treated site after the procedure to decrease post procedure discomfort.  We also recommend taking a NSAID such as ibuprofen or naproxen immediately after the procedure. If you can't take any NSAID's, then you can take Tylenol.

When will I get pain relief?

Pain relief can occur anywhere from four to six weeks after the procedure. The hope is that relief from this procedure will last around 9 to 12 months, but this varies. Some patients have experienced multiple years of pain relief after radiofrequency ablation. Pain can return after the nerve regenerates, but if you received successful pain relief, the procedure can be repeated.


  • Other Treatments

  • Conservative Therapy
  • Joint Injection
  • Lumbar Epidural Injection
  • Lumbar Radiofrequency Ablation (RFA)
  • Medial Branch Block
  • MLS Laser Therapy
  • Peripheral Nerve Stimulation
  • Regenerative Therapy
  • Sacroiliac Injection (SI)
  • Spinal Cord Stimulation For Diabetic Foot Pain
  • Sympathetic Nerve Block
  • Trigger Point Injection