Radiofrequency ablation, often shortened to RFA, uses heat to interrupt the nerves carrying pain signals from a specific joint to your brain. It does not remove the source of the pain. It quiets the messenger.
For people whose back or neck pain comes from arthritic facet joints, RFA is often the treatment that finally gives them a meaningful stretch of relief after injections have only helped for a few weeks at a time.
What radiofrequency ablation treats
RFA is most commonly used for pain coming from the small facet joints of the spine, in the lower back or the neck. It is also used for sacroiliac joint pain and, in some cases, for knee pain from osteoarthritis.
It is generally considered when two things are true: your pain has been traced to a specific joint, and a diagnostic block confirmed that numbing the nerves to that joint takes the pain away.
Why the diagnostic block comes first
We do not go straight to ablation. Before RFA, we perform a medial branch block, a small injection of local anesthetic onto the specific nerves we are considering treating.
If that injection substantially reduces your pain, even briefly, it tells us we have found the right nerves. If it does not, we have learned something equally valuable, and we look elsewhere rather than performing a procedure that was never going to help.
That step matters. It is the difference between treating your pain and guessing at it.
How the procedure works
Every procedure Dr. Serpa performs is image guided, using live X-ray or ultrasound. You lie face down, the skin is numbed, and a thin needle with an insulated tip is guided to the target nerve.
Before any heat is applied, the position is tested. A small electrical signal confirms we are on the correct sensory nerve and safely away from the nerves that control your muscles. Once confirmed, the tip is heated for a short period to interrupt the nerve.
Most people are in and out in under an hour. You are awake, though light sedation is available if you would prefer it.
What to expect afterward
Expect some soreness at the injection sites for a few days, similar to a deep bruise. Some people notice relief within a few days. For others it builds over two to three weeks as the treated nerves settle.
Relief from RFA is not permanent, because treated nerves regenerate over time. Many patients experience meaningful relief for a period of months before the procedure needs repeating, and RFA can generally be repeated when the pain returns.
Your own results depend on your anatomy, the source of your pain, and how your body responds. Dr. Serpa will talk through what is realistic for your situation rather than quoting you an average.