What are Radiofrequency Ablation Devices?

Radiofrequency ablation (RFA) devices use radio waves to heat and destroy tiny areas of nerve tissue. The goal is to disrupt the pain signals traveling to the brain. The most common type of RFA device uses a probe or catheter that contains an electrode tip that delivers radiofrequency energy. This creates heat that damages the tissue cells in a small, targeted area. Several small painful areas can be treated during one session. For chronic pain management, RFA aims to decrease or eliminate pain signals.

How RFA Works for Pain Relief

During an RFA procedure, a local anesthetic is usually administered before inserting the RFA device probe or catheter near the affected nerves or tissues causing pain. Using imaging for guidance like ultrasound, fluoroscopy or CT, the electrode tip is maneuvered to the precise area. Radiofrequency energy is delivered, raising tissue temperature to around 65-90°C (149-194°F), causing an electric field that agitates water molecules in the targeted cells. This disrupts cellular membranes and proteins in a very small treatment region. The goal is to damage nerves without necessarily destroying them entirely, by controlling the amount of thermal energy delivered. Once the targeted nerves or tissues are coagulated, the probe is removed. The treated area swells and forms scar tissue which helps disrupt pain signals to the brain over time. Multiple, thin exposures are preferred over fewer larger ablations.

Common Areas Treated with Radiofrequency Ablation Devices For Pain Management

Some common anatomical areas treated with Radiofrequency Ablation Devices For Pain Management include facet joints, sacroiliac joints, spinal discs and surrounding tissues, peripheral nerves, and trigger points.

• Facet Joint RFA: Small joints located posteriorly along the spine that may cause neck or back pain if inflamed or arthritic. RFA targets medial branch nerves that innervate facet joints.

- Sacroiliac Joint RFA: Joint between the sacrum and each ilium of the pelvis that causes low back and pelvic pain. The posterior sacral nerves are targeted.

- Discogenic Back Pain RFA: Treatment of painful lumbar or cervical discs using intradiscal probes to cauterize nociceptive nerve fibers within and around the disc.

- Peripheral Nerve RFA: Targets specific nerves like the genicular nerve for knee pain, or lumbar medial branches for groin or hip pain.

- Trigger Point RFA: Highly localized zones of muscle tightness often implicated in migraine headaches, tension headaches, and some forms of myofascial pain can be treated.

Benefits and Effectiveness of RFA

- Minimally invasive, requiring only local anesthesia in most cases. No major surgical risks compared to procedures like nerve ablation or cutting.

- Provides targeted treatment of specific pain generators with limited collateral thermal injury to surrounding tissues.

- Reduces or eliminates pain temporarily, and sometimes permanently, by disrupting pain signal transmissions along affected nerves or tissues.

- Involvement of image guidance improves accuracy and reduces risks compared to blind procedures.

- Short recovery time, usually allowing return to normal activities within a day or two.

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