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Lumbar radiofrequency ablation How RFA eases chronic lower back pain from the facet joints, step by step
Lumbar radiofrequency ablation (RFA) uses gentle heat on the small medial branch nerves that carry pain from the facet joints of the lower back. It is considered for chronic low back pain, usually lasting three months or more, when the exam and tests suggest the facet joints as a likely source and therapy and medicine have not given lasting relief. One or two test blocks with numbing medicine come first. If they clearly relieve your usual pain, ablation can calm those nerves for about six to twelve months, sometimes longer.
Chronic low back pain has many possible causes, including muscle and ligament strain, disc problems, a pinched nerve, the sacroiliac joint and arthritis in the small facet joints at the back of the spine. When the facet joints are the likely source, the pain is often a dull ache across the lower back that is worse with standing, arching backward or twisting, and may spread into the buttocks. Lumbar radiofrequency ablation targets the nerves that carry that pain. The videos show Ashley Marcus, MD performing the procedure and the test block that comes first.
Who lumbar radiofrequency ablation may help
- Chronic lower back pain lasting three months or more, with an exam that points to the facet joints; see facet joint pain
- Arthritis of the lower spine; see lumbar spondylosis
- People who have tried physical therapy for back pain, exercise and medicine without lasting relief
- People who are not candidates for surgery, or want to avoid it
It is not designed for sciatica, pain that shoots down the leg from a pinched nerve. That pattern has different causes and treatments, such as an epidural steroid injection.
The test blocks come first
Before ablation, your physician performs a medial branch block: numbing medicine is placed next to the nerves of the painful facet joints under X-ray guidance. If your usual back pain clearly drops for the hours the medicine lasts, those nerves are likely the source. Most plans repeat the block once to confirm. A clear response to the blocks is the best predictor that lumbar RFA will help.
What happens during the procedure
- You lie face down; the skin is cleaned and numbed
- Using fluoroscopy (live X-ray), the physician places a thin needle with an electrode next to each target nerve
- A brief test confirms the position, then the nerve is numbed
- Radiofrequency heat is applied for about a minute or two per nerve
- You rest briefly and go home the same day with a driver
The visit usually takes about an hour. Pain procedures are performed at all three offices, and your physician explains where and when yours will be scheduled.
Results and recovery
Soreness at the needle sites for a few days is common, and some people feel a sunburn-like sensitivity in the skin for a week or two. Relief usually builds over two to four weeks and often lasts six to twelve months or longer. Because the nerves slowly regrow, the procedure can be repeated if pain returns. Our guide to radiofrequency ablation recovery covers the first days and weeks, and the pain-free window is the best time to build strength with core exercises for back pain. For the neck, see neck radiofrequency ablation.
More videos: lumbar RFA and the test block
More clips from our YouTube channel @precisioncaremedical showing how the test block and lumbar RFA work.
Related care at Precision Care Medical & Sports Performance
Lumbar radiofrequency ablation near you
Looking for radiofrequency ablation near me, or a back pain doctor near me? Precision Care Medical & Sports Performance evaluates chronic lower back pain at all three offices, where our pain physicians, Ashley Marcus, MD in Brooklyn, Jake Stephen, DO on Staten Island and Yuri Gordin, MD in Manhattan review your exam and imaging and decide whether medial branch blocks and ablation fit. Our Brooklyn pain management office on Shell Rd is close to Brighton Beach, Coney Island and Bensonhurst.
Our Staten Island pain management office on Richmond Rd serves New Dorp, Midland Beach and Grasmere. In Manhattan, the Precision Care Spine & Pain Center in Midtown Manhattan is a direct ride from Washington Heights and Spanish Harlem. See also our back pain doctor page. Request an appointment or call the office closest to you.
150 E 55th St, Suite 401, New York, NY 10022
(212) 840-0135
Questions patients ask
Is lumbar radiofrequency ablation painful?
The skin is numbed first, and most people feel pressure and some warmth. Soreness at the needle sites for a few days is common.
How long does lumbar radiofrequency ablation last?
Relief often lasts six to twelve months and sometimes longer. The nerves slowly regrow, so the procedure can be repeated if the pain returns.
Why do I need a medial branch block before RFA?
The block shows whether the facet joint nerves are carrying your pain. If numbing them clearly relieves your usual pain, ablation is more likely to help.
Can lumbar RFA help sciatica?
It is not designed for sciatica. RFA treats pain from the facet joints; leg pain from a pinched nerve has other causes and treatments.
When can I go back to work after lumbar RFA?
Most people return to desk work within a day or two. Avoid heavy lifting and hard workouts for a few days, as your physician advises.
Where can I get lumbar radiofrequency ablation near me?
Precision Care Medical & Sports Performance evaluates lower back pain and plans lumbar radiofrequency ablation at all three offices:
- Brooklyn2781 Shell Rd, Suite 101, Brooklyn, NY 11223(718) 648-1234 · Get directions
- Staten Island1630 Richmond Rd, Suite 101, Staten Island, NY 10304(718) 339-7100 · Get directions
- Midtown Manhattan150 E 55th St, Suite 401, New York, NY 10022(212) 840-0135 · Get directions
Physical therapy for the back is offered at the Brooklyn and Staten Island offices only.
Educational only, not medical advice. These videos and this article explain common problems and treatments in general terms. They are not a diagnosis or a treatment plan for you. Results vary from person to person. See a qualified clinician about your own symptoms, and call 911 or go to an emergency room for an emergency.
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