• Radiofrequency Pain Management

    Radiofrequency (RF) is a minimally invasive procedure that uses a high-frequency electric current to produce heat and electric field targeting nerve tissue, thereby interrupting pain signals from that specific area. 

    There are 2 types of radiofrequency used in pain management : 

    1. Continuous RF or Thermal RF or RF ablation : The target is to get a controlled heat effect, usually up to 80’C, to “burn” the nerve. 
    2. Pulsed RF : The main target is to expose the nerve or tissue to the electric field generated from the RF needle. Th electric field has been scientifically proven to reduce inflammation response and cause neuromodulation effect (cellular changes of the nerve) that can reduce the intensity of pain signals. 

    The pain specialist will insert a specialized needle by ultrasound guidance or fluoroscopy (x-ray) guidance to a targeted nerve. 

    When the needle is near the affected nerve, the pain specialist will perform a nerve stimulation test by observing a certain muscle contraction or ask the patient if they feel any tingling sensation. This is important to ensure that the needle is near the correct nerve. 

    After the nerve stimulation confirms the needle position, the RF is performed. 

    Both local anesthesia and a mild sedative may be used to reduce discomfort during the procedure. 

    Studies have shown that radiofrequency is effective for up to two years in reducing pain, although the results may vary depending on the individual case and the specific procedure. 

    Some proven effective radiofrequency treatment : 

    • Trigeminal Neuralgia : 91-93% success rate with  81% persistent pain relief even after 18 months
    • Cervicogenic Headaches : 86% success rate for RF of the C2-3 facet source of pain, with a median duration of 10 month pain relief 
    • Neck Pain due to cervical facet pain: 80% success rate with good-to-excellent pain relief over 1 year
    • Back Pain due to lumbal facet pain : 87% success rate with at least 60% pain relief lasting more than 12 months
    1. Minimally Invasive: RFA is a minimally invasive procedure, which means it can often be performed on an outpatient basis with minimal discomfort to the patient. This translates to shorter hospital stays, quicker recovery times, and reduced overall healthcare costs.

    2. Precision and Selectivity: RFA allows us to precisely target specific nerves or nerve clusters responsible for transmitting pain signals. This level of precision means we can achieve pain relief without causing widespread nerve damage or affecting other bodily functions.

    3. Long-Lasting Relief: Unlike some other pain management techniques that provide temporary relief, RFA can offer long-lasting pain reduction. This is because the thermal lesion created during the procedure disrupts the nerve’s ability to send pain signals for an extended period.

    4. Enhanced Quality of Life: By effectively alleviating chronic pain, RFA can significantly improve patients’ quality of life. Patients experience reduced pain intensity, improved physical function, and increased ability to engage in daily activities.

    5. Reduction in Medication Dependency: RFA can often lead to a reduction in the need for pain medications, which is particularly important in the current landscape of opioid concerns and addiction issues.

    Reference : Erdine, Serdar, et al. Interventional pain management: image-guided procedures. Eds. P. Prithvi Raj, and Leland Lou. Philadelphia: Saunders Elsevier, 2008.