Radiofrequency Neurotomy

Everything you’d like to know about having Radiofrequency Neurotomy to manage your pain.

Interventus Pain Specialists conducts Radiofrequency Neurotomy (RFN) to help manage a range of persistent pain issues in our patients. Find out about how the procedure is performed, the benefits and risks, and what you can expect when you come to hospital.

Why do I need Radiofrequency Neurotomy?

RFN is a needle-based procedure used to treat pain that originates from the posterior spine structures, such as the facet or sacroiliac joints. The procedure involves placing needles onto the medial branch nerve, which is the nerve that supplies the joints at the back of the spine. High-frequency electrical energy is used to create a heat lesion that blocks the medial branch nerve from sending pain signals.

RFN has been well researched and is established as the most effective treatment for facet joint pain that has failed to respond to other measures. Patients assessed as suitable for this treatment have a general success rate of about 75%.

How is the procedure performed?

• An anaesthetist will be present during your procedure to ensure you feel as comfortable as possible
• You will be comfortably positioned lying face down with pillow supports under your legs and chest
• Before the procedure starts, a small needle (cannula) will be inserted into your hand or arm so that sedation can be administered as necessary
• Your back will be cleaned with antiseptic solution and then covered with sterile drapes
• Local anaesthetic will be injected to make the skin area numb and you may feel a sharp sting
• An X-ray machine is used to help guide the needle and when your Interventus Pain Specialist is happy with the location of the needle, a small solution of local anaesthetic will be injected.
• After the procedure, you will return to the recovery area where the nursing team will carry out observations, give you something to eat and drink and make sure you are safe to go home.

How long will the relief last?

Over time, the medial branch nerve will regain function and your pain may return. On average, patients can experience pain relief for nine months, however, this does vary. If the procedure needs to be repeated in the future, the success rate increases to about 90%.

Are there any risks?

All medical procedures carry a risk of side effects and possible complications.

Common risks and complications for RFN include:

• Bleeding or bruising
• Backache due to the muscle being aggravated by the needle
• Temporary leg or arm weakness due to local anaesthetic
• A burning sensation, similar to sunburn, in the overlying skin that can sometimes last up to six weeks
• An increase in pain for the first few days

Less common risks and complications include:

• Not able to perform the procedure due to medical and/or technical reasons
• Infection requiring further medical treatment
• Allergies
• Damage to surrounding structures that may need further treatment

How do I prepare for my procedure?

At least two weeks before your procedure, inform your Interventus Pain Specialist if you:

• Are taking blood thinners, including fish oils, turmeric or aspirin
• Are diabetic
• May possibly be pregnant
• Are allergic to iodine, betadine, chlorhexidine, shellfish, local anaesthetics or steroids
• Have a temperature, feel unwell or possibly have an infection

You must have a responsible adult (over the age of 18) collect you after the procedure and stay with you overnight. You must not drive a vehicle or make important decisions for 24 hours following your procedure.

What happens on the day of my procedure?

• Please have no food within 6 hours prior to your procedure
• You may drink water up to 2 hours prior to your procedure, but no more that 200mls per hour
• Take your regular medication with a small sip of water
• Shower the morning of your procedure

What do I do after discharge?

• Take it easy for 24 hours
• Resume your usual diet and drink plenty of fluids
• For procedural pain, use cold packs and simple analgesics such as paracetamol
• Gentle mobilisation is recommended
• Usual activity may be recommenced as you feel up to it
• Avoid bathing/soaking until the injection sites have healed

It may take two to three weeks before you start to notice an improvement in your pain.

After discharge, if you notice:

• Swelling
• Bleeding from the injection site
• Changes in sensation
• Difficulty moving your arms or legs
• Any new symptoms
• Difficulty passing urine

Please contact Interventus Pain Specialists during office hours, your GP or present to your nearest Emergency Department.

What happens next?

• Please call Interventus Pain Specialists to make a follow-up appointment
• Your Pain Specialist will determine the effectiveness of the procedure and develop a tailored and comprehensive pain management plan