Radiofrequency ablation, often called RFA, is a minimally invasive pain management procedure that uses controlled radiofrequency energy to interrupt pain signals traveling through carefully selected nerves.
At TOPS Institute, our board-certified interventional pain management specialists perform image-guided radiofrequency procedures for patients with chronic neck pain, lower back pain, knee pain, and sacroiliac joint pain throughout Los Angeles, Beverly Hills, and Southern California.
RFA may be considered when pain has continued despite physical therapy, medication, activity modification, injections, or other conservative treatments. It is commonly used after diagnostic nerve blocks confirm that a specific group of nerves is contributing to the patient’s symptoms.
Our goal is to reduce pain, improve mobility, and help patients return to daily activities with less reliance on medication and without major surgery whenever medically appropriate.
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What Is Radiofrequency Ablation?
Radiofrequency ablation is a targeted procedure that uses heat generated by radiofrequency energy to treat a small area of nerve tissue responsible for transmitting pain signals.
During the procedure, the physician places a specialized needle near the targeted nerve using fluoroscopic X-ray or ultrasound guidance. A small electrode within the needle delivers controlled radiofrequency energy, creating a precise thermal lesion that temporarily interrupts the nerve’s ability to send pain signals.
RFA does not remove the painful joint or correct every structural problem. Instead, it reduces the transmission of pain signals from the affected area.
Because the treated nerves may regenerate over time, pain relief is not always permanent. However, many patients experience meaningful improvement lasting several months or longer.
How Does Radiofrequency Ablation Work?
Radiofrequency ablation typically involves the following steps:
- The painful structure is identified through examination, imaging, and diagnostic injections.
- One or more diagnostic nerve blocks are performed when appropriate.
- If the blocks provide significant temporary relief, RFA may be recommended.
- During treatment, the targeted nerve is located using image guidance.
- Radiofrequency energy is applied to interrupt pain transmission.
- The patient returns home after a brief recovery period.
The procedure is generally performed with local anesthetic. Light sedation may be used in selected cases, depending on the treatment area, medical history, and facility protocol.
Conditions Treated With Radiofrequency Ablation
RFA may be used to treat chronic pain associated with:
- Cervical facet joint arthritis
- Lumbar facet joint arthritis
- Cervical spondylosis
- Lumbar spondylosis
- Facet joint syndrome
- Sacroiliac joint dysfunction
- Knee osteoarthritis
- Chronic knee pain
- Persistent knee pain after joint replacement
- Mechanical neck pain
- Mechanical lower back pain
- Degenerative spinal conditions
- Selected post-surgical pain conditions
RFA is most effective when the painful nerve pathway has been carefully identified before treatment.
Cervical Radiofrequency Ablation
Radiofrequency Treatment for Chronic Neck Pain
Cervical radiofrequency ablation targets the medial branch nerves that carry pain signals from the facet joints in the neck.
The cervical facet joints are small joints located along the back of the cervical spine. These joints may become painful because of arthritis, degeneration, repetitive strain, or trauma such as whiplash.
Cervical RFA may be considered for patients with:
- Chronic neck pain
- Cervical facet joint syndrome
- Cervical spondylosis
- Neck arthritis
- Whiplash-related pain
- Pain that worsens with rotation or extension
- Headaches originating from the upper cervical joints
- Referred pain into the shoulders or upper back
Symptoms of cervical facet pain may include:
- Aching neck pain
- Neck stiffness
- Pain when turning the head
- Pain when looking upward
- Tenderness along the cervical spine
- Reduced range of motion
- Pain near the base of the skull
- Referred pain into the shoulder blades
Before cervical RFA, diagnostic medial branch blocks are commonly used to determine whether the targeted facet joints are contributing to the pain.
During the procedure, fluoroscopic guidance helps the physician position each radiofrequency needle near the appropriate medial branch nerve. Controlled energy is then delivered to interrupt the pain signal.
Lumbar Radiofrequency Ablation
Radiofrequency Treatment for Chronic Lower Back Pain
Lumbar radiofrequency ablation targets the medial branch nerves that transmit pain from the facet joints in the lower back.
Lumbar facet joint pain is often caused by arthritis, age-related degeneration, repetitive stress, injury, or abnormal spinal mechanics.
Lumbar RFA may be recommended for:
- Chronic lower back pain
- Lumbar facet joint syndrome
- Lumbar spondylosis
- Lumbar facet arthritis
- Mechanical lower back pain
- Pain following spinal degeneration
- Selected cases of persistent pain after spine surgery
Symptoms of lumbar facet pain may include:
- Aching pain across the lower back
- Pain that worsens with standing
- Pain with twisting or bending backward
- Stiffness after inactivity
- Referred discomfort into the buttocks or upper thighs
- Tenderness over the lower spine
Lumbar facet pain usually does not follow the same radiating nerve pattern as sciatica. Patients with pain extending below the knee, numbness, tingling, or weakness may require evaluation for disc herniation, spinal stenosis, or nerve-root compression.
Before lumbar RFA, patients typically undergo medial branch blocks. Significant temporary relief from these diagnostic blocks can indicate that the facet joints are a likely source of pain.
Genicular Radiofrequency Ablation
Radiofrequency Treatment for Chronic Knee Pain
Genicular radiofrequency ablation targets sensory nerves surrounding the knee joint. These nerves, known as the genicular nerves, transmit pain signals from the knee without controlling the major muscles responsible for movement.
Genicular RFA may be considered for patients with:
- Knee osteoarthritis
- Chronic knee pain
- Moderate to severe degenerative joint disease
- Persistent pain after knee replacement
- Knee pain that has not improved with injections
- Pain that limits walking, exercise, or physical therapy
- Medical conditions that make surgery less appropriate
Before treatment, a diagnostic genicular nerve block may be performed. If the block provides meaningful temporary relief, radiofrequency ablation may be considered.
During the procedure, fluoroscopy or ultrasound is used to identify the anatomical locations of the targeted genicular nerves. Radiofrequency energy is then applied to reduce the transmission of pain signals.
Genicular RFA does not repair damaged cartilage or reverse arthritis. Its purpose is to reduce pain, improve function, and help patients move more comfortably.
Many patients use the period of pain reduction to participate more effectively in physical therapy, weight management, strengthening, and other joint-preserving strategies.
Sacroiliac Joint Radiofrequency Ablation
Radiofrequency Treatment for SI Joint Pain
Sacroiliac joint radiofrequency ablation is used to treat chronic pain arising from the sacroiliac joints, which connect the lower spine to the pelvis.
The sacroiliac joints absorb forces between the upper body and legs. They may become painful because of arthritis, injury, pregnancy-related changes, repetitive stress, altered walking mechanics, or degeneration.
SI joint RFA may be considered for patients with:
- Sacroiliac joint dysfunction
- Chronic buttock pain
- Lower back pain linked to the SI joint
- Sacroiliitis
- Pain after pelvic or spinal injury
- Pain that has temporarily improved after diagnostic injections or nerve blocks
Symptoms of sacroiliac joint pain may include:
- One-sided lower back pain
- Buttock pain
- Pain near the posterior pelvis
- Pain when standing from a seated position
- Pain while climbing stairs
- Discomfort with prolonged standing
- Pain when turning in bed
Sacroiliac joint radiofrequency ablation generally targets the lateral branch nerves that carry pain signals from the posterior portion of the joint.
Image guidance is used to position the treatment needles near the appropriate nerve branches. Controlled radiofrequency energy is then delivered to reduce pain transmission.
Learn more about Sacroiliac Joint Injections.
Radiofrequency Ablation vs. Steroid Injections
Steroid injections and radiofrequency ablation are both minimally invasive procedures, but they work differently.
Steroid injections
Steroid injections are used to reduce inflammation within or around a painful joint or nerve.
They may provide temporary relief lasting days, weeks, or months depending on the diagnosis and patient response.
Radiofrequency ablation
RFA treats the nerves carrying pain signals from the affected structure.
It is often considered after diagnostic blocks confirm the painful nerve pathway and may provide longer-lasting relief than an injection alone.
The most appropriate procedure depends on the source of pain, previous treatments, diagnostic findings, and overall health.
Medial Branch Blocks Before RFA
For cervical and lumbar facet pain, diagnostic medial branch blocks are an important part of the evaluation process.
A medial branch block temporarily numbs the small nerves that supply the facet joints.
The procedure may help answer two important questions:
- Are the facet joints contributing to the patient’s pain?
- Is radiofrequency ablation likely to provide meaningful relief?
Patients are often asked to track their pain level, mobility, and ability to perform previously painful activities after the block.
The amount and duration of relief help guide treatment decisions.
What Happens During Radiofrequency Ablation?
Radiofrequency ablation is generally performed on an outpatient basis.
The typical process includes:
Pre-Procedure Evaluation
Your physician reviews your symptoms, medical history, medications, diagnostic blocks, imaging studies, and treatment goals.
Positioning
You are positioned according to the area being treated.
Sterile Preparation
The skin is cleaned, and local anesthetic is used to numb the treatment area.
Image Guidance
Fluoroscopy or ultrasound is used to position the needle near the targeted nerve.
Sensory and Motor Testing
In some procedures, low-level electrical stimulation may be used to confirm that the needle is close to the intended sensory nerve and away from important motor nerves.
Radiofrequency Treatment
Controlled radiofrequency energy is delivered through the electrode for a specified period.
Recovery
You are monitored briefly before returning home.
The procedure often takes approximately 30 to 60 minutes, although the total appointment may be longer when preparation and recovery are included.
Benefits of Radiofrequency Ablation
Longer-Lasting Pain Relief
Many patients experience relief lasting several months or longer after a successful procedure.
Minimally Invasive Treatment
RFA requires no large incision and is typically performed on an outpatient basis.
Reduced Reliance on Medication
Effective pain control may reduce the need for frequent pain medication in selected patients.
Improved Mobility
Reducing pain may make walking, exercising, sleeping, and participating in physical therapy easier.
Targeted Treatment
RFA treats specific nerves identified through clinical evaluation and diagnostic blocks.
Potential to Delay Surgery
For appropriate patients, RFA may help manage pain without immediate spine or joint surgery.
How Long Does Radiofrequency Ablation Last?
Pain relief often lasts approximately 6 to 12 months, although some patients experience a shorter or longer response.
The duration of relief depends on:
- The condition being treated
- The accuracy of the diagnosis
- Response to diagnostic blocks
- The nerves treated
- The severity of arthritis or degeneration
- Overall health
- Participation in rehabilitation
- Individual nerve regeneration
Because nerves can regrow, symptoms may return over time. Repeat treatment may be considered if the first procedure provided meaningful relief and the pain returns.
When Will I Feel Relief?
Pain relief is not always immediate.
Some patients notice improvement within several days, while others may require two to four weeks before experiencing the full benefit.
It is common to have temporary soreness, sensitivity, or a mild increase in pain after the procedure while the treated area heals.
Recovery After RFA
Most patients return home the same day.
Common aftercare recommendations may include:
- Resting for the remainder of the day
- Avoiding strenuous activity for a short period
- Using ice as directed
- Monitoring the treatment area
- Resuming medications according to instructions
- Gradually returning to normal activity
- Continuing physical therapy when recommended
Most patients resume routine activities within one to three days, although soreness may last longer.
Patients who receive sedation generally need a responsible adult to drive them home.
Is Radiofrequency Ablation Safe?
Radiofrequency ablation is generally considered safe when performed by an experienced physician after an appropriate diagnostic evaluation.
Potential risks include:
- Temporary soreness
- Bruising
- Swelling
- Bleeding
- Infection
- Temporary numbness
- Increased pain
- Neuritis or nerve irritation
- Muscle spasm
- Skin sensitivity
- Allergic reaction
- Rare nerve injury
- Rare injury to surrounding structures
Individual risk depends on the treatment area, anatomy, health history, medications, and procedure technique.
Patients taking blood thinners or those with active infection, bleeding disorders, implanted devices, uncontrolled medical conditions, or certain neurological disorders may require additional evaluation.
Do not stop prescribed blood-thinning medication unless your physicians provide coordinated instructions.
Who Is a Good Candidate for RFA?
You may be a candidate if you:
- Have chronic pain lasting several months
- Have pain associated with facet joints, the knee, or SI joint
- Have not improved sufficiently with conservative care
- Experienced temporary relief from diagnostic nerve blocks
- Want a minimally invasive treatment option
- Are able to safely undergo the procedure
- Have pain that limits daily activity or rehabilitation
RFA may not be appropriate when pain is caused by an untreated fracture, infection, tumor, major neurological compression, or another condition requiring urgent treatment.
When Should You Seek Immediate Medical Attention?
Seek urgent evaluation for pain accompanied by:
- New loss of bladder or bowel control
- Rapidly worsening weakness
- Saddle-area numbness
- Fever with severe spinal pain
- Major trauma
- Sudden inability to walk
- Severe joint swelling with fever
- Progressive neurological symptoms
These symptoms may indicate a condition that should not be treated with routine radiofrequency ablation alone.
Related Treatments
Facet Joint Injections
Facet joint injections may reduce inflammation and help identify whether a cervical or lumbar facet joint is contributing to pain.
Learn more about Facet Joint Injections.
Medial Branch Blocks
Medial branch blocks temporarily numb the nerves supplying the spinal facet joints and may help determine whether a patient is a candidate for RFA.
Sacroiliac Joint Injections
SI joint injections may provide diagnostic information and temporary relief for sacroiliac joint pain.
Learn more about Sacroiliac Joint Injections.
Knee Joint Injections
Knee injections may include corticosteroid, viscosupplementation, or other targeted treatments for arthritis and inflammation.
Learn more about Joint Injections.
Platelet-Rich Plasma
High-Dose PRP may be considered for selected musculoskeletal injuries and degenerative joint conditions.
Learn more about Platelet-Rich Plasma Therapy.
Physical Therapy
Rehabilitation can improve strength, flexibility, posture, joint mechanics, and long-term function after pain is reduced.
Why Choose TOPS Institute?
At TOPS Institute, radiofrequency ablation is performed as part of a comprehensive, individualized pain management plan.
Patients choose our practice for:
- Board-certified interventional pain management physicians
- Fluoroscopic and ultrasound image guidance
- Careful diagnostic nerve blocks
- Cervical, lumbar, knee, and sacroiliac expertise
- Personalized treatment planning
- Minimally invasive procedures
- Concierge-level patient support
- Convenient care in Los Angeles and Beverly Hills
- A focus on mobility and long-term function
We carefully evaluate whether the targeted nerves are likely to be responsible for your symptoms before recommending treatment.
Frequently Asked Questions
What is radiofrequency ablation?
Radiofrequency ablation is a minimally invasive procedure that uses controlled heat to interrupt pain signals traveling through selected sensory nerves.
What conditions can RFA treat?
RFA may be used for cervical or lumbar facet joint pain, spinal arthritis, sacroiliac joint pain, knee osteoarthritis, chronic knee pain, and selected post-surgical pain conditions.
What is cervical radiofrequency ablation?
Cervical RFA targets the medial branch nerves that carry pain signals from the facet joints in the neck. It may help patients with chronic neck pain caused by cervical facet arthritis or spondylosis.
What is lumbar radiofrequency ablation?
Lumbar RFA treats the medial branch nerves supplying painful facet joints in the lower back. It is commonly used for chronic mechanical lower back pain and lumbar facet arthritis.
What is genicular radiofrequency ablation?
Genicular RFA targets sensory nerves surrounding the knee. It may help reduce chronic pain caused by knee osteoarthritis or persistent pain after knee replacement.
What is sacroiliac joint radiofrequency ablation?
Sacroiliac joint RFA targets the nerve branches that transmit pain from the posterior SI joint. It may help patients with confirmed chronic sacroiliac joint pain.
Do I need a nerve block before RFA?
Diagnostic nerve blocks are commonly performed before cervical, lumbar, genicular, or SI joint RFA. A positive response helps confirm the targeted nerve pathway.
Is radiofrequency ablation painful?
Most patients experience pressure, warmth, or brief discomfort. Local anesthetic is used, and light sedation may be available for selected patients.
How long does RFA take?
Most procedures take approximately 30 to 60 minutes, although the total visit may be longer because of preparation and recovery.
How long does radiofrequency ablation last?
Relief commonly lasts six to twelve months, although results vary. Some patients experience relief for a shorter or longer period.
How quickly will I feel better?
Some patients improve within several days, while others may take two to four weeks to notice the maximum benefit.
Can the nerves grow back?
Yes. The treated nerves may regenerate over time, which is why pain can eventually return. Repeat treatment may be considered when the original procedure was successful.
Can RFA permanently damage my mobility?
The nerves targeted during pain RFA are generally sensory branches rather than the major motor nerves controlling movement. Image guidance and testing help reduce the risk of affecting surrounding structures.
Is RFA better than a steroid injection?
Neither procedure is universally better. Steroid injections reduce inflammation, while RFA interrupts pain signals. The correct option depends on the diagnosis, pain source, and response to diagnostic procedures.
How many times can RFA be repeated?
Repeat treatment may be considered when pain returns after a successful procedure. The timing and appropriateness depend on the patient’s response, diagnosis, and overall health.
How much does radiofrequency ablation cost in Los Angeles?
Cost varies depending on the treatment area, number of nerves treated, facility, imaging guidance, sedation, insurance coverage, and other clinical factors. Our office can help review available cost and coverage information before treatment.
Take the First Step Toward Long-Lasting Pain Relief
Chronic neck, back, knee, or sacroiliac joint pain can make everyday movement difficult. If diagnostic nerve blocks indicate that a specific nerve pathway is contributing to your symptoms, radiofrequency ablation may offer meaningful, longer-lasting relief.
Contact TOPS Institute to schedule a comprehensive consultation with an interventional pain management specialist in Los Angeles or Beverly Hills.
Book an Appointment Today
