Back pain is generally due to small nerves called nociceptors located around the spine. These nociceptors are responsible for pain perception, sensation, balance and muscle movement. They supply the facet joints, the various spinal ligaments, the outer wall of the intervertebral disc, and the fibrous covering of the bone called the periosteum. Radio Frequency Nerve Ablation (RF) is used to treat pain originating from these nerve endings.
Prior to performing a radio frequency nerve ablation, a doctor usually administers numbing medication in order to identify the precise location of pain. If the numbing medicine relieves the pain, then the radio frequency procedure is performed in the same area.
The patient remains awake during the procedure, while the doctor then inserts a small needle into the pain area. Using fluoroscopy (television x-ray) for guidance, the doctor inserts a tiny electrode through the needle and administers a small radiofrequency current. Ideally, this heats and numbs the problem nerves eliminating pain. Some surgeons are also using the RF probe to ablate painful tissue during arthroscopic and endoscopic surgery of the spine and extremity joints.
In the past, nerve ablation was also called a rhizotomy, and was performed either surgically (by cutting the nerve), chemically with toxic substances, with high heat (through a process called electro cauterization), or by freezing the nerve (cryoablation). The Holmium laser is also used by some doctors to perform a laser nerve ablation.
Success rates have been extremely variable. The pain has a tendency to recur in six to eight months because the nerves grow back. In a few cases, however, relief can last longer.