Radiofrequency (RF) Lesioning is a procedure using electrical impulses to interrupt nerve conduction on a semi-permanent basis. The nerves are usually blocked for 6 to 12 months. The procedure disrupts nerve conduction (especially conduction of pain signals) and it may reduce other related symptoms (numbness, tingling, or burning). Approximately 70-80% of patients will get good block of the intended nerve. This should relieve the pain that the blocked nerve controls. Once a nerve is blocked, it sometimes becomes clear that there is also some pain generated from different areas.
Since nerves cannot be seen on x-ray, the needles are positioned using bony landmarks that indicate where the nerves usually are. Fluoroscopy (x-ray) is used to identify those bony landmarks. A local anesthetic (like Novocain) is injected to numb superficial tissue. The special RF needle is then inserted under X-ray guidance. For most patients, the insertion of the RF needle will cause a dull pressure, not pain. After confirmation of the needle tip position, a special needle tip is inserted. When the needle is in good position, as confirmed by x-ray, electrical stimulation is done before the RF Lesioning. This stimulation may produce a buzzing or tingling sensation or may be like hitting your “funny bone”. You may also feel your muscles jump. You need to be awake during this part of the procedure so you can report to the doctor what you feel. The tissues surrounding the needle tip are then heated when electronic current is passed using the Radio Frequency machine, for 90-120 seconds. This “numbs” the nerves semi-permanently.