Lumbar Radiofrequency Ablation (RFA)

  1. What is a Lumbar Radiofrequency Ablation?

    A lumbar radiofrequency ablation (RFA) is an outpatient procedure for treating low back, buttock, hip, and groin pain. It is also called lumbar facet thermal coagulation or rhizotomy. RFA uses radiofrequency energy to disrupt nerve function. When this is done to a lumbar medial branch nerve, the nerve can no longer transmit pain from the injured facet joint.

  2. What are lumbar facet joints?

    Facet joints connect the vertebrae, the bones of the spine. They help guide your spine when you move. The low back area of the spine is called the lumbar region. It contains five vertebrae. Facet joints are found on both sides of the spine. Each is about the size of a thumbnail. Lumbar facet joints are named for the vertebrae they connect and the side of the spine where they are found. The right L2-3 facet joint, for example, joins the 2nd and 3rd lumbar vertebrae on the right side. Medial branch nerves are found near facet joints. They communicate pain from the facet joints. They tell the brain when a facet joint has been injured.

  3. How do I know if I have lumbar facet pain?

    Lumbar pain may present as muscle tension or as severe pain. Lumbar facet joint pain can occur in an area from your low back down to your buttocks, groin, and hip. If this pain lasts more than two months, you may have lumbar facet pain. Common tests such as x-rays or MRIs may not show if a facet joint is causing pain. The best way to diagnose facet pain is to block the pain signal in the medial branch nerve with a local anesthetic (numbing medication).

  4. What happens during an RFA?

    A local anesthetic will be used to numb your skin. Your doctor will then insert a thin needle near the facet joint. Fluoroscopy, a type of x-ray, must be used to position the needle. The doctor will then check to make sure it is at the correct nerve by stimulating it. This may cause muscle twitching and provoke some of your pain. Once the needle is properly placed, the nerve will be numbed. Radiofrequency energy will then be used to disrupt the medial branch nerve. This is often repeated at more than one level of the spine.

  5. What happens after an RFA?

    You will be monitored for up to 30 minutes after the RFA. When you are ready to leave, the staff will give you discharge instructions. Take it easy for the rest of the day. You may feel sore for one to four days. It may be due to muscle and nerve irritation. Your low back may feel numb, weak, or itchy for a couple weeks. Maximum pain relief normally comes in two or three weeks.

  6. How long can I expect relief?

    Nerves regenerate after an RFA, but how long this takes vary. Your pain may or may not return when the nerve regenerates. It if does occur, another RFA can be done.