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Neuroablation/Radiofrequency Denervation

Peripheral nerve blocks are most commonly used when pain medication escalation is limited by side-effects. Some patients, however, will benefit from one component of their pain being relieved by a peripheral nerve block as part of a comprehensive, multi-pronged plan.

When pain arises from nerve injury or from cancer, these nerves can play a vital role in pain relief. When nerve blocks are given in combination with other therapy, including pain medications, radiation therapy, and chemotherapy, their use may allow significant relief while avoiding side-effects from escalation of pain medications.

If nerve blocks do not provide sustained relief, radiofrequency denervation of the nerves can be considered. For peripheral nerves that provide muscular function, radiofrequency denervation with high temperature cauterization is not an option because of potential loss of function. In this case, a different means of applying the energy, a “pulsed” energy, will be used to “stun” the nerve. Pain signals are minimized while the nerve still retains its normal function.

Radiofrequency

Radiofrequency ablation is performed using a specialized needle that can be guided under live x-ray visualization directly toward a targeted peripheral nerve. Radiofrequency energy is then transmitted via a probe inserted into the special needle. This needle allows the radiofrequency probe to create a focused energy lesion to “burn” or “stun” the targeted peripheral nerve.

How it Works

Peripheral nerve radiofrequency denervation can be performed with either the assistance of landmarks that can be easily felt by touch (palpation), or under imaging guidance (a live x-ray or ultrasound machine) to increase the accuracy of this procedure. 

  • During the procedure, you will be asked to lie in a position to facilitate access to the peripheral nerve. 
  • The targeted area of your body will be prepped with a cleaning solution, and then a sterile drape will be placed. 
  • Your JLR Center for Pain Medicine physician will first anesthetize your skin with numbing medicine.
  • Next, a special radiofrequency needle will be advanced toward the intended target area. Radiofrequency energy is then transmitted via a probe inserted into the special needle. This needle allows the radiofrequency probe to create a focused energy lesion to “burn” or “stun” the nerve and prevent it from sending pain signals.
  • A local anesthetic and sometimes a steroid (cortisone) may be administered afterward as an anti-inflammatory.
  • A dressing is placed over the place of needle entry after the procedure.

Risks

As with any other procedure, there are potential risks (although very low) of infection, bleeding, allergic reaction, and prolonged increases in pain. Your JLR Center for Pain Medicine physician will use x-ray guidance and sterile techniques throughout the procedure to significantly reduce the risks as well as nerve damage.