Medically reviewed by: Dr. John A. Serpa, MD, DABA, board-certified in Anesthesiology with a subspecialty in Pain Medicine
Last updated: September 25, 2026
If your lower back aches and stiffens when you stand, twist, or lean back, and feels better when you sit or bend forward, your facet joints may be the source. Radiofrequency ablation (RFA) is a minimally invasive, image-guided procedure that quiets the small nerves carrying pain from those joints. For patients whose pain is confirmed by a diagnostic nerve block, RFA typically provides four months to a year of relief, with no incision and no hospital stay.
TL;DR Medical Summary: Radiofrequency ablation treats chronic low back pain from the facet joints by using controlled heat to interrupt the small medial branch nerves that carry pain signals. Candidates are confirmed first with a diagnostic nerve block. Relief typically lasts four months to a year, and treatment can be repeated.
What is facet joint pain?
Facet joint pain comes from the small paired joints that link each vertebra to the next. When these joints wear down from arthritis, injury, or years of strain, they produce a steady ache that makes standing, twisting, and leaning back uncomfortable.
It usually feels like a dull ache on one or both sides of the lower spine, often with morning stiffness. It can spread into the buttock or back of the thigh but typically stops above the knee. Pain that shoots below the knee with numbness or tingling points more toward a disc problem or sciatica. Learn more about low back and facet joint pain.
How is facet joint pain diagnosed?
Imaging alone can’t confirm it, because many people have arthritic facet joints on an MRI that don’t hurt at all. The most reliable test is a diagnostic medial branch block: if numbing the nerves to a joint temporarily relieves your pain, that joint is very likely the cause.
- Exam and history. Dr. Serpa or the care team reviews your symptoms, what you’ve tried, and any existing imaging.
- Diagnostic block. Under live X-ray, numbing medicine is placed next to the nerves that serve the suspected joints, and you track your pain over the next few hours.
- Confirmation. Most patients need one or two blocks, depending on how clearly they respond and what their insurance requires.
If the blocks bring clear relief, you’re likely a good candidate for RFA. See facet joint injections and medial branch blocks.
How does radiofrequency ablation relieve back pain?
RFA uses a thin needle with a heated tip to interrupt the medial branch nerves that carry pain from the facet joints. The joint isn’t changed, but its pain signal is turned down for months.
These nerves only report how the joint feels. They don’t control your leg muscles, so treating them can reduce pain without affecting strength. Dr. Serpa primarily uses conventional (thermal) RFA, and every needle is positioned with live X-ray before any heat is applied. Read more on our radiofrequency ablation page.
What happens during the procedure?
RFA is an outpatient procedure done while you lie face down, usually with local anesthesia while you stay awake. You go home the same day.
- Numbing. Local anesthetic numbs the skin and deeper tissue. Light sedation is available in some cases.
- Needle placement. Dr. Serpa guides each needle to its target using live X-ray.
- Treatment. The nerve is numbed, and then heat is applied for a short cycle at each target.
- Discharge. You’re observed briefly and go home with written aftercare instructions.
What is the recovery time after RFA?
Most people return to light activity within a day or two, though the area may stay sore for one to two weeks. Pain relief builds gradually and can take up to three weeks to show up fully.
Some patients notice a temporary sunburn-like sensitivity over the treated area, which usually fades on its own. Don’t judge your results in the first week. Call the office right away if you have a fever, redness or drainage at a needle site, new leg weakness or numbness, or severe worsening pain.
For a day-by-day breakdown, see our RFA recovery timeline.
How long does radiofrequency ablation last?
Relief typically lasts four months to a year. Because the treated nerves slowly regrow, pain can return, and RFA can usually be repeated if the first treatment worked well.
In Dr. Serpa’s experience, many patients begin to notice some pain returning around four to five months after treatment, while others go a year or longer. Using the pain-free window to build core and back strength helps protect your results.
Is radiofrequency ablation safe?
RFA is considered low-risk when performed by a trained physician under image guidance, and serious complications are rare. The most common side effects are temporary soreness and a brief burning or numb feeling over the treated area.
Less often, nerve irritation can cause burning pain for a few weeks. Infection and bleeding are rare. Tell us before your procedure if you take blood thinners, have a pacemaker or other implanted device, could be pregnant, or have an active infection.
Who is a good candidate for RFA?
The best candidates have had low back pain for at least three months, haven’t found enough relief with physical therapy or medication, and had clear relief from a diagnostic block. RFA is less likely to help when the main problem is shooting leg pain from a pinched nerve.
For that kind of nerve pain, an epidural steroid injection is often a better fit.
How does RFA compare with other treatments?
RFA sits between conservative care and surgery: it lasts longer than a steroid injection and is far less invasive than spine surgery. For confirmed facet joint pain, it’s often the next step when therapy and medication haven’t been enough.
| Treatment | How invasive | Recovery | How long relief lasts |
|---|---|---|---|
| Physical therapy and medication | Not invasive | None | As long as the routine continues |
| Facet joint steroid injection | Needle only | Same or next day | Often weeks to months |
| Radiofrequency ablation | Needle only, no incision | 1 to 2 days | Typically 4 months to a year, repeatable |
| Spine surgery | Incision | Weeks to months | Intended to be long-term |
Why choose Today I Have No Pain in Hialeah?
Results with RFA depend on an accurate diagnosis, so it matters who evaluates you and who places the needle. Dr. John A. Serpa, MD, DABA, is board-certified in Anesthesiology with a subspecialty in Pain Medicine, and every procedure is performed with live image guidance.
Most new patients are seen within days of calling. Our office at 1800 W 68th St, Suite 114, serves Hialeah, Hialeah Gardens, Miami Lakes, Miami Springs, and all of Miami-Dade, with free parking and se habla español.
Ready to find out what’s causing your back pain? Request an appointment or call (305) 698-9077.
Frequently asked questions
The area is numbed with local anesthetic first, so most patients feel pressure and brief discomfort rather than sharp pain. Soreness afterward is common for a few days and is usually managed with ice and the pain relievers your care team recommends.
No. The treated section of the nerve gradually regrows over months, which is why relief isn’t permanent and why the procedure can be repeated.
Many plans, including Medicare, cover RFA for facet joint pain when diagnostic requirements are met, such as documented relief from medial branch blocks. Ask our office about your plan’s specific requirements.
If you receive sedation, you’ll need an adult to drive you home. If you have local anesthesia only, ask the care team ahead of time whether you’ll need a driver.
This guide is for general education and is not a substitute for medical advice. Individual results vary, and not every patient is a candidate for RFA. If you are having a medical emergency, call 911.
References
- Cleveland Clinic. Radiofrequency Ablation (RFA): What It Is & Procedure. https://my.clevelandclinic.org/health/treatments/17411-radiofrequency-ablation
- Mayo Clinic Health System. Radiofrequency ablation for back pain. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/radiofrequency-ablation-pain-relief
- Van den Heuvel, et al. Pain originating from the lumbar facet joints. Pain Practice, 2024. https://onlinelibrary.wiley.com/doi/10.1111/papr.13287
- Long-term function, pain and medication use outcomes of radiofrequency ablation for lumbar facet syndrome. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4440581/