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Radio Frequency Lesioning (RFL)

What is Radiofrequency Lesioning (RFL)?

This is an outpatient procedure using a specialized machine to interrupt nerve conduction on a semi-permanent basis. Pain relief may last for at least 6 to 18 months. This procedure is performed using Fluoroscopy. Fluoroscopy is a type of X-ray that identifies bony structures. A local anesthetic is used to numb an area on the skin. After confirmation of needle tip placement, a small electrical current is passed through the needle to perform sensory and motor testing. Finally, an electrode is used to send a radio wave frequency, which turns the nerve off.

What are the pre-requisites in order to perform this procedure?

In order to perform the RFL, we would need to perform two separate diagnostic test injections, called Medial Branch Blocks (MBB). These injections consist of different types of numbing medications. Depending on the amount of pain relief after these injections, we may continue to proceed with the final RFL procedure.

How long does the RFL procedure take?

The procedure takes about 30 minutes.

Will the procedure hurt?

This should easily be tolerated by the patient with only mild sedation. Intravenous sedation and analgesia will be available. This makes the procedure easier to tolerate. It is necessary for you to be awake enough to communicate easily during the procedure. We also numb the skin and deeper tissues with a local anesthetic prior to inserting the needle. There is moderate discomfort involved for a few weeks after. You may have numb areas with increased sensitivity (like a deep sun burn).

What should I expect after the procedure and what are the side effects?

Initially, there will be muscle soreness for up to 7-10 days afterward. Ice packs will usually control this discomfort. After the first 4-6 weeks, your pain may be gone or quite less. Some patients may have some “deep sun burn” type of feeling. Some may develop hypersensitivity or burning pain, or numb areas for a few weeks.

What should I do after the procedure?

You should have a ride home. We advise the patients to take it easy for a day or so after the procedure. You may want to apply ice to the affected area. Perform activities as tolerated.