To decrease pain by interrupting (burning) the sensory nerve pathways using a temperature monitored probe. Patients receiving radiofrequency (RFTC) are usually patients wherein more conservative treatment modalities have not been successful in providing adequate pain relief. These patients may have experienced neck, shoulder, back or leg pain for a long time. The technique may also be used to treat cervicogenic headaches.

Prior to the procedure, an intravenous (IV) will be started and you will be placed on a monitor that will check your blood pressure and heart rate. You will be asked to lie on your stomach supported by pillows. A nurse will give you some sedating medication through your IV and will monitor you throughout the procedure. You will not be asleep, because it is important for your to answer questions accurately during the entire procedure. You should experience reduced anxiety with partial or total amnesia.

A radiology technologist will use an X-ray machine to locate the exact areas targeted for the procedure. Your back will be cleaned with a special solution and draped with sterile drapes. The doctor will numb the area with local anesthetic. You will then feel a pressure sensation and a moderate amount of discomfort when the doctor inserts each needle into the correct location.

Once the needles are inserted, the doctor will test the sensory nerves of each target area and will ask you where you feel various sensations. Testing is not painful. Patients usually report a "tingling" or "pressure" sensation. The temperature probe will then be placed in each target location just long enough to burn the sensory nerve pathways. The burning does cause discomfort for 30-40 seconds at each location. When completed, the doctor will inject local anesthetic and low-dose steroid at each site before removing each needle. The Medication is injected near nerves providing loss of sensation to the area of pain. When the procedure is over, you will be asked to lie down for 30 minutes on your back with an ice pack on the injection sites while you continue to be monitored.

• The procedure may not help your pain.
• You may experience bruising at the injection sites.
• Small risk of bleeding or infection at the site of the lesion.
• Very small risk of temporary or permanent damage to the nearby spinal nerve root or the spinal cord resulting in paralysis or partial muscle weakness or persistent numbness.
• Very small risk that your pain will become worse or result in residual pain.
• Rarely, reactions to the anesthetic drugs can cause flushing, ringing in your ears, or in very rare instances, seizures or respiratory depression.
• Allergic reactions to medications may cause your heart and breathing to stop or cause death.

• Your pain will become worse for 1-2 weeks while the burned areas heal. For this reason, patients are instructed not to become discouraged. The real result of RFTC will not be experienced until after this two-week period.
• Temporary numbness, tingling, or weakness in one or both extremities (arms or legs) may occur, but will wear off within a few hours. If these symptoms worsen or continue, please call The Pain Treatment Center or the on-call doctor.

It is not possible to predict to what extent, if any, this treatment will relieve your pain. Usually radiofrequency provides long-term (i.e., 3 months or more), but the results vary with each individual situation. If the pain returns, it may be necessary to perform another radiofrequency lesioning at some point in the future. To be most effective, radiofrequency lesioning should be combined with programmed exercises to strengthen and stabilize the affected joints. Your pain management doctor may discuss types of exercise with you. Your doctor may also recommend that you schedule an appointment with our Behavioral Medicine doctors to discuss stress management techniques. You may also be asked to stop smoking.