Treatment information
Understanding your pathway
What is the treatment?
Radiofrequency ablation uses a controlled heat lesion near selected sensory nerves to interrupt pain signalling. The target may be a medial branch nerve supplying a spinal facet joint or another defined articular nerve. It is different from pulsed radiofrequency, and it does not repair an arthritic joint or disc. [1][2][3]
Who may be considered?
For selected chronic localised low back pain, NICE recommends considering radiofrequency denervation only after an appropriate assessment and a positive diagnostic medial branch block. Other targets, such as knee nerves, need their own evidence and selection discussion. An abnormal scan or persistent pain alone is not enough. [1][2][3]
Assessment, preparation and consent
Before deciding, discuss your diagnosis, previous treatment, medicines and relevant health conditions. Tell the clinician about allergies, infection, blood-thinning medicines, diabetes and possible pregnancy. Do not stop prescribed medicines yourself. Ask what alternatives are available, including not having a procedure, and allow time to consider the benefits, uncertainty and risks that matter to you. [4]
What happens during treatment?
A specialised needle is positioned using imaging. The clinician may use stimulation to assess proximity to sensory and motor structures before treatment. Local anaesthetic and sedation arrangements depend on the procedure. The exact nerves, technique and plan for avoiding unintended motor injury should be explained before consent. [1][2][3]
Risks and safety considerations
Possible risks include bleeding, infection, pain flare, neuritis, numbness, burns and unintended nerve injury. The consequences depend on the target, nearby structures and your health. Pain can worsen, and benefit is not assured. Ask which risks are especially relevant to the proposed spinal or joint procedure. [1][2][3]
Recovery and when to seek help
Follow the written instructions for transport, supervision, medicines, activity and driving. Recovery depends on the treatment and your health, so a fixed return-to-work date cannot be promised. Ask who to contact outside clinic hours. Seek urgent assessment for fever with worsening pain, new weakness or other unexpected neurological symptoms. Call 000 for breathing difficulty, collapse or another medical emergency. [5][4]
Expected benefit and limitations
The degree and duration of benefit vary, and pain can recur. A positive block does not guarantee a successful ablation. Avoid assuming a fixed period of relief or automatic repeat treatment. Follow-up should review function and adverse effects as well as pain, while maintaining an appropriate rehabilitation plan. [1][2][3]
Follow-up and rehabilitation
Before treatment, choose a practical goal such as walking, sleep or a daily task. Record changes in that activity, pain and any adverse effects, then discuss them at follow-up. Ask what degree of change would justify further treatment and what would lead to stopping or changing the plan. Rehabilitation and self-management may remain part of care even if symptoms improve. [4][6]
Questions to bring to your appointment
Ask which structure is being targeted, why this approach is being considered and how strong the evidence is for your diagnosis. Clarify costs, the planned review date and any practical help you may need at home. Bring previous reports and your medicine list so the discussion can address your circumstances rather than a generic treatment pathway.
Sources and further reading
Sources support the statements cited above. Overseas guidance may describe different services or eligibility rules. A procedure leaflet explains a technique and its risks; it does not establish that the treatment is effective for every condition.
- Low back pain and sciatica: recommendations — NICE
- Genicular nerve block with or without radiofrequency ablation — Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust
- Facet joint injections and medial branch block — The Dudley Group NHS Foundation Trust
- Procedures in pain medicine clinical care standard — Faculty of Pain Medicine, ANZCA
- Dorsal root ganglion / nerve root block / transforaminal injection — Hull University Teaching Hospitals NHS Trust
- Options for chronic pain management — Healthdirect Australia