Long term solutions to chronic pain are very important, and now that the FDA is limiting availability of opioids it it becoming increasingly important to know what options are available. One such form of treatment is nonsurgical procedure known as nerve ablation.
One method of accomplishing this is the use of extreme cold (cryoblation). Techniques that employ a chemical such as phenol or alcohol (chemical neurolysis) encompass the second of these methods. Thirdly is a technique known as radiofrequency ablation (RFA), which is the topic of my blog post today.
The "pros" of RFA include the fact that it is reproducible. RFA is also extremely precise, and highly effective. The RFA technique is also known to have a good margin of safety, so patients can have a sense of relief about that!
A little background...
The earliest accounts or RFA can be traced back to the 1930s. It has been noted that this technique was used as a treatment for trigeminal neuralgia. More widespread availability of this RFA treatment became possible in the 1950s, when the work Cosman and Arrow produced the first commercial radiofrequency machine Since this is meant to be a long term treatment, diagnostic nerve blocks are commonly employed to help determine if this is an appropriate treatment for an individual patient.
How does RFA work?
To use radiofrequency as a medical treatment, a high frequency current is created by a generator. It is then sent through an electrode into body tissues; it travels on to a grounding pad where the circuit is completed. During is passage through body tissue, the current heats up the tissue around it, forming a lesion, which eventually becomes a scar. Over the next 3 or so weeks, the scar area of treatment undergoes changes, eventually forming the desired "nerve block." The size of the affected area can be adjusted using different sized electrodes, duration of treatment, and control of temperature that is reached in the treated tissues.
Pulsed radiofrequency (PRF) is a variation of this technique. During pulsed RF there are brief pulses of high voltage current. This helps to control the temperature in such a way as to avoid excessive heating, and a more reversible, less destructive outcome than the traditional method.
What chronic pain issues is RFA used for?
Here is a list of some of the clinical applications of RFA:
Some possible complications can include treatment failure, bleeding, and neuritis. Other complication such as weakness and paralysis.
And lastly, the good news!
The degree of pain relief is variable. It depends on the cause and location of the pain.
Pain relief from RFA can last from six to 12 months. In some cases, relief can last for years!
Over 70% of patients treated with RFA experience pain relief!
Source: Radiofrequency Treatment in Chronic Pain
One method of accomplishing this is the use of extreme cold (cryoblation). Techniques that employ a chemical such as phenol or alcohol (chemical neurolysis) encompass the second of these methods. Thirdly is a technique known as radiofrequency ablation (RFA), which is the topic of my blog post today.
The "pros" of RFA include the fact that it is reproducible. RFA is also extremely precise, and highly effective. The RFA technique is also known to have a good margin of safety, so patients can have a sense of relief about that!
A little background...
The earliest accounts or RFA can be traced back to the 1930s. It has been noted that this technique was used as a treatment for trigeminal neuralgia. More widespread availability of this RFA treatment became possible in the 1950s, when the work Cosman and Arrow produced the first commercial radiofrequency machine Since this is meant to be a long term treatment, diagnostic nerve blocks are commonly employed to help determine if this is an appropriate treatment for an individual patient.
How does RFA work?
To use radiofrequency as a medical treatment, a high frequency current is created by a generator. It is then sent through an electrode into body tissues; it travels on to a grounding pad where the circuit is completed. During is passage through body tissue, the current heats up the tissue around it, forming a lesion, which eventually becomes a scar. Over the next 3 or so weeks, the scar area of treatment undergoes changes, eventually forming the desired "nerve block." The size of the affected area can be adjusted using different sized electrodes, duration of treatment, and control of temperature that is reached in the treated tissues.
Pulsed radiofrequency (PRF) is a variation of this technique. During pulsed RF there are brief pulses of high voltage current. This helps to control the temperature in such a way as to avoid excessive heating, and a more reversible, less destructive outcome than the traditional method.
What chronic pain issues is RFA used for?
Here is a list of some of the clinical applications of RFA:
- lumbar facet arthropathy (most common)
- cervical facet issues --eg chronic whiplash
- lower back pain (sacroiliac joint)
- intervertebral disc pain
- dorsal root/sympathetic ganglia problems
- headaches (trigeminal ganglion, cluster headaches
- phantom limb pain
Some possible complications can include treatment failure, bleeding, and neuritis. Other complication such as weakness and paralysis.
And lastly, the good news!
The degree of pain relief is variable. It depends on the cause and location of the pain.
Pain relief from RFA can last from six to 12 months. In some cases, relief can last for years!
Over 70% of patients treated with RFA experience pain relief!
Source: Radiofrequency Treatment in Chronic Pain
Expert Rev Neurother. 2010;10(3):469-474.
http://www.webmd.com/pain-management/radiofrequency-ablation
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