Radiofrequency Ablation for Back Pain: Long-Lasting Relief Without Surgery
If you've been getting steroid injections for back or neck pain and finding that the relief wears off after a few months — radiofrequency ablation (RFA) may be the longer-lasting solution you've been looking for.
RFA provides 12–18 months of relief from facet-mediated pain using outpatient heat energy to disable pain-carrying nerves. No incision. No implant. No surgery. And it can be repeated when the nerves regenerate.
How RFA Works
The small nerves that carry pain signals from the facet joints — called medial branch nerves — are the target of RFA. Using a specialized radiofrequency needle placed under fluoroscopic (X-ray) guidance, a controlled heat lesion is created at each nerve target (80°C for 60–90 seconds). This disables the nerve's ability to transmit pain signals from the arthritic facet joint.
The procedure is outpatient. You go home the same day.
Who Is a Candidate?
RFA is appropriate for patients who:
- Have chronic neck or back pain from facet joint disease (arthritis, injury, or degeneration)
- Have responded positively to two sets of diagnostic medial branch blocks — confirming the facet joints as the pain source
This two-block requirement is the evidence-based standard and is usually required by insurance for coverage approval. If you've had positive medial branch blocks elsewhere but haven't proceeded to RFA, our office can review your history.
The Procedure Experience
You lie face-down on the procedure table. The area is numbed. Dr. Rubin places RFA cannulas under X-ray guidance, performs electrical testing to confirm correct positioning and safety, then performs heat ablation at each target level. Multiple levels can be treated in a single session.
Most patients experience soreness and muscle aching for 1–2 weeks after the procedure — this is normal and expected as the treated area heals. Pain relief builds gradually over 2–6 weeks.
How Long Does It Last?
Medial branch nerves will regenerate over time — typically 12–24 months. When pain returns, the procedure can be repeated with equivalent results. Some patients go years between procedures.
Comparing Options
| Treatment | Duration | Mechanism | |---|---|---| | Medial branch block | 2–6 hours | Local anesthetic | | Facet joint steroid injection | 1–4 months | Anti-inflammatory | | Radiofrequency ablation | 12–18 months | Nerve ablation |
For patients tired of repeat injections every 3–4 months, RFA represents a significant quality-of-life improvement.
Call 516-492-3100 to find out if you're a candidate for radiofrequency ablation.