Radiofrequency Ablation

This treatment uses radiofrequency energy to heat tissue in a very small area (5 mm) to nullify the specific pain nerves feeding facet joints, a common cause of back pain. We target these nerves based on the results of previous diagnostic injections to the medial branch nerves. We use X-ray guidance to precisely place a small needle next to the targeted nerve and then radiofrequency waves are generated at the needle tip.

Over 80% of patients will receive long-term pain relief from radiofrequency ablation (RFA), lasting 6-18 months. The re-growing of nerves accounts for the return of symptoms.

HOW DO I PREPARE FOR MY PROCEDURE?

• If you are on anticoagulation drugs (Plavix, Coumadin, Warfarin etc.) you may need to have an international normalized ratio (INR) test and stop your medication prior to the procedure. Please inform our booking coordinators of any blood thinners you may be taking, so that they can discuss further instructions with you.
• If you are currently taking antibiotics, you will need to wait two days after your last dose to be able to have your injection done.
• Take all prescribed medications as directed.
• You must have someone accompany you on the day of your test.
• Have a light snack one hour before your arrival.
• Please arrive 30 minutes before your appointment to allow enough time to check in with reception.
• Bring photo identification and your provincial health card.
• Wear comfortable clothes.

WHAT HAPPENS DURING MY PROCEDURE?

• A team member will review the consent form, explain procedure details, and answer any questions.
• We will assess your leg strength and provide you with a comfortable clinic gown to change into.
• We will then escort you to our treatment suite where you will meet the radiologist and be positioned on the table for your exam.
• The radiologist will use X-ray guidance to correctly position a thin tube and administer a generous amount of local freezing.
• The radiologist will confirm the correct location by viewing the needle from multiple angles and may test the probe location, if needed.
• We will let you know when the nerve ablation has begun, a process which takes two minutes for each site. Band-Aids will be placed over the treatment areas.
• A team member will enter with a stretcher and you will be asked to roll on to it.
• You will be brought into a recovery room, an ice pack will be applied, and we will monitor you for an additional 15-30 minutes post-procedure.
• You will be assessed by our team and, if there are no concerns, you will be free to leave with your driver.

POST-PROCEDURE INSTRUCTIONS

• First 24 hours:
  • Keep the treatment area clean and dry. Leave the Band-Aid on. Do not shower.
  • Avoid driving.
  • Avoid strenuous activities and lifting.
  • If possible, please avoid anti-inflammatory medication for 24 hours (i.e., ibuprofen/Advil).
• First 48 hours: Avoid bathtubs, hot tubs, and pools.
• After one week: You may resume physiotherapy. Be mindful of your pain and stop if it hurts too much. Notify your physiotherapist that you have had this injection so they can modify your exercises if necessary.
• Sometimes pain could feel worse for one to two weeks. It could take up to one month for the nerve to completely lose function. Use Tylenol or previously prescribed pain medications (as per their original prescription directions), intermittent ice packs, or Voltaren gel to manage pain.
• You may experience sunburn-like sensation or itchiness. This is transient and can be managed by applying Voltaren gel to the affected area.
• If there is concern for significant bleeding or infection, such as worsening pain, skin redness at the area of injection, or a temperature greater than 38.5°C, please proceed to a walk-in clinic or urgent care centre.
• If sudden intense lower back pain comes on quickly and travels down one or both legs, please go to an urgent care centre.
• Anti-coagulant therapy: You will be directed when to resume any anti-coagulant (blood thinners) medication.
• If you have questions or concerns, please call 403-568-3890 to speak with a nurse or radiologist. If you are unable to reach us, please call Health Link (811) or 911, and proceed to the nearest emergency room or medical centre.

WHEN WILL I SEE RESULTS?

• Sometimes pain could feel worse for one to two weeks. It could take up to one month for the nerve to completely lose function.
• Over 80% of patients will receive long-term pain relief from RFA, lasting 6-18 months. The re-growing of nerves accounts for the return of symptoms.

HOW MUCH WILL IT COST?

This exam is covered under your Alberta Health Care Plan. It is not currently offered at our Saskatchewan clinics.