Radiofrequency ablation when applied to nerves can act as a type of rhizotomy or selective nerve root destruction.
While this sounds terrifying, it’s a very simple minimally invasive procedure usually performed at a clinic or doctor’s office. Radiofrequency ablation recovery time depends on the patient, but patients who receive this procedure often go home on the very same day.
What is Radiofrequency Ablation?
The idea behind radiofrequency ablation is to selectively destroy tissue in the body via hyperthermia, or overheating, through a needle or probe. The tip of the needle is superheated through an electrical current oscillating at a radio frequency. Doctors use a special catheter or needle to guide a metal tip or probe to the ablation site, then destroy the target tissue with the heat generated by the current passing through the probe.
The frequency used is critical, because it allows the process to seamlessly remove dysfunctional tissue without interfering with or stimulating nearby nerves and muscles. This means the body isn’t receiving any electrical shocks, nor is the heat strong enough to affect other parts of the body.
This means radiofrequency ablation can be performed without general anesthesia and can even be used to destroy heart tissue contributing to an arrhythmia without interfering with the function of the heart.
In most cases, radiofrequency ablation is used in the destruction of cancer tissue (tumors), dysfunctional heart tissue, aesthetic dermatology, and pain management. When used in the treatment of neuropathic pain, it is also called rhizotomy.
When is Radiofrequency Ablation Considered?
For chronic pain management, radiofrequency ablation is only considered if the pain is considered neuropathic, or nerve-related. If a patient’s pain can be traced back to a dysfunctional nerve root, a targeted ablation may provide long-lasting pain relief. Examples of conditions where radiofrequency ablation may be considered include:
- Chronic lower back pain
- Neck pain
- Arthritis of the spin
- Facet joint inflammation
- Sacroiliac joint inflammation
- Peripheral neuropathy
An important indication for radiofrequency ablation is that other, more conservative treatments haven’t worked. Patients that are candidates for radiofrequency ablation may potentially also be candidates for chemical nerve blocks (similar process but utilizing neurolytic agents or corticosteroids instead of heat).
One way doctors test for neuropathic pain originating at a nerve root is through local anesthesia. A local anesthetic like lidocaine is injected into the area surrounding the nerve root.
If a patient’s pain subsides significantly afterward, then ablating that nerve root can provide longer relief by cutting off pain signals traveling from the spine to the brain. This is a very targeted procedure, meaning it doesn’t affect other nerve roots, nor does it affect related motor nerves.
The doctor will simply be in and out with the probe, temporarily destroying the dysfunctional nerve root and allowing the patient to return to their normal life pain-free.
Radiofrequency Ablation is Temporary
It is important to note that radiofrequency ablation is temporary. While these nerve roots are being ablated with heat, the damage dealt with them is not meant to last forever. They will recover function over time, which may or may not lead to a return of pain.
Sometimes, ablating and letting the nerve root heal again can reduce or improve symptoms in the long run. Other times, it helps give patients enough of a window to find other ways to reduce the likelihood of returning pain.
The period in which the nerve regains its function depends on the nerve and the patient. Some function is usually regained within three to 15 months.
Radiofrequency Ablation Recovery Time
Patients who have gone through radiofrequency ablation are usually kept under observation for anywhere from a quarter to a full hour. A nurse will check in on your blood pressure and vital signs until you’re cleared to leave.
Your doctor or medical team will go over any potential discomfort or side effects you might experience, as well as symptoms to keep an eye out for that may require calling in for additional help. Call your doctor immediately if you notice severe swelling at the injection site, severe pain, leg weakness, or redness/bruising.
You will be given a timeline for when you can resume normal activities. It is typically advised that you avoid strenuous activity for one to two weeks after receiving a radiofrequency ablation, which is also roughly the time it takes for general discomfort to subside. Aside from taking it easy, you will also be advised to:
- Refrain from driving or operating any machinery for 24 hours. Have someone pick you up or call a cab.
- Shower but avoid soaking in a bath for at least one or two days.
- Remove any bandages the next day.
- There are no restrictions on diet. While you will be asked to refrain from eating the day of the procedure, you can resume eating normally after you have been discharged.
Your doctor may also prescribe some over-the-counter painkillers to help deal with pain at the injection site. Do not apply ice or heating pads to the injection site itself.
Preparing for the Procedure
Because it’s a minimally invasive procedure, there isn’t much to prepare for. It is advised to have an empty stomach, so try to time your last meal about six hours before your appointment. You can have clear liquids up until two hours before the procedure.
On the day of your procedure, you will be awake, but maybe sedated partially, through both local anesthesia and a mild sedative applied intravenously. Once you’re relaxed and medicated, the procedure will begin. Your doctor will guide a catheter to the pain site, utilizing x-ray imaging to get close to the problematic nerve. Then, utilizing radiofrequency ablation, the needle at the end of the catheter will heat up and destroy the target tissue.
Radiofrequency Ablation Recovery Time: The catheter will be removed, a bandage will be placed on the skin, and you will be asked to rest for a little while before being discharged.
Long-Term Care and Future Treatment
As mentioned previously, radiofrequency ablation of a nerve is temporary. It can take up to four weeks for the full effects of the pain relief to kick in, as your body recovers and heals from the procedure. Radiofrequency ablation may only be one part of a larger treatment plan, including other medication and physical therapy. Ablation can help reduce the pain that might have made physical therapy and exercise near impossible before, helping you manage your pain more effectively when the nerve heals.
Nerve roots are peripheral nerves, which means that they can reform and heal over time. And because the ablation is usually minuscule, the nerve can fully reform in time. It may take anywhere from a few months to over a year for the nerve to regain full function. The pain may or may not return with it. Your doctor will walk you through your options for long-term pain management afterward, including further ablation, or other procedures.
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