What is Radiofrequency Neurotomy?

• Radiofrequency neurotomy procedures are performed to treat pain arising from joints, such as facet joint pain, sacroiliac joint pain, as well as certain headaches.
• The prodedure involves the delivery of alternating electrical current to the pain generating nerve via an electrode that is contained within a needle. This dense electrical current generates heat (above 60°C) at the tip of the needle. This damages the nerve in order to provide pain relief.
• Before this procedure is undertaken, the joints and branch nerves will already have been proven to be painful by a diagnostic form of spinal injection, and will not have responded to other treatment methods.
• The procedure may provide pain relief for many months, after which the nerve will regenerate and the pain may return.
• This procedure is always performed using X-ray control in the day surgery.
• For more information on radiofrequency neurotomy procedures, read our educational news article on Radiofrequency Neurotomy.

Prior to the Procedure

• All blood thinning products (except aspirin) must be stopped prior to your procedure. You will be advised by letter when to stop taking these medications at the time that your admission date is arranged.
• You are able to take your other regular medications with a sip of water on the morning of your procedure.
• If you are an insulin dependent diabetic you will always be at the beginning of the list. Please bring your insulin with you and it will be given to you following your procedure.
• Hamilton Day Surgery Centre staff will advise you of your fasting and admission times.
• You must not have anything to eat, drink, smoke or chew prior to your procedure.
• You will need to organise someone to drive you home after the procedure as you will not be able to drive for 24 hours after your procedure.

What Will Happen?

1. You will be admitted to the day surgery by a nurse and you will be asked to change into a gown.
2. The anaesthetist will speak with you and place a cannula (plastic needle) into a vein in your hand.
3. In the procedure room, you will be assisted to position on the procedure table on your abdomen with a pillow under your hips and abdomen. A special earthing pad will be placed on the back of your leg. For cervical medial branch radiofrequency, you will be positioned on your side with the affected side up most.
4. The anaesthetist will give you some sedation into your vein.
5. An X-ray machine will be used to determine where the doctor will place the needle for your procedure. The entire procedure will take around 30 to 40 minutes to complete.
6. Once correct placement has been achieved using X-ray guidance, sensory (and sometimes motor) stimulation will be performed. You will be asked to let the staff know when you feel a tingling sensation (sensory stimulation). It is very important that you let the staff know as soon as you feel this sensation.
7. On completion of sensory stimulation, local anaesthetic will be applied and then radiofrequency neurotomy will commence. You should not experience any pain due to the local anaesthetic being applied. Each radiofrequency lesion takes 90 seconds and generally at least 2 lesions are done at each level.
8. After the procedure, you will be placed on a trolley and taken to recovery, where you will remain for approximately 1 hour.
9. After having something to eat and drink, you will be discharged with a carer.

Post Procedure

• Gentle activity and rest is recommended in the first 24 hours following the procedure. You may then return to normal activity.
• It is recommended that you apply cold packs to your injection sites for the first 24 hours following your procedure. After this time, you may apply heat packs if you prefer.
• You may experience discomfort at the radiofrequency site for around 5 days.
• A nurse from HPC will telephone you 24 to 48 hours following your procedure to discuss the outcome of your procedure and organize a follow-up appointment.

If you require further explanation of the procedure, please contact Hunter Pain Specialists nursing staff on (02) 4985 1800.