Reviewed by Tyler Tice, PT, DPT, OCS, ATC
This peer-reviewed article aims to identify the indications, technique, and complications of radiofrequency ablation (RFA). RFA is a minimally invasive procedure that utilizes high-frequency alternating electrical current to generate heat, resulting in targeted tissue destruction. Thermal energy is applied near or on peripheral nerve origins along the spinal cord. Parameters for temperature are designed to spare sensory and motor fibers, targeting only the dorsal root ganglia, which are responsible for transmitting ascending information, such as pain, touch, and temperature.
Indications for this procedure include chronic back and neck pain. Additionally, RFA has been used for radicular pain, discogenic pain, facetogenic pain, post-herpetic neuralgia, post-amputation pain, and post-inguinal herniorrhaphy pain. Contraindications to RFA include patient refusal, increased intracranial pressure, and local infection.
Radio frequency currents are guided via a catheter to an electrode near a nociceptive pathway to intercept pain impulses. The currents heat the surrounding tissue, and the tissue, in turn, heats the electrode. When the target temperature is reached, the current cycles on and off to maintain it.
Potential adverse effects include bleeding, infection, needle placement-induced nerve damage, and burns. Of these, the most common complication is temporary post-procedure discomfort. Other complications may involve alopecia, pigmentation changes (particularly with facial involvement), and neuropathic pain.
The duration of analgesia is dependent on the reinnervation of the targeted tissues by the proximal axons, which typically ranges from weeks to months. In conclusion, RFA should not be used as a stand-alone treatment and is not a substitute for other methods of pain management, but an adjunct treatment.
Reference:
Ray JK, Dixon B, Przkora R. Radiofrequency Ablation. [Updated 2023 Jun 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482387/