Radiofrequency Ablation

What radiofrequency ablation is

Nerves that supply the capsule of a joint carry sensory information, including pain, back toward the spinal cord. Radiofrequency ablation is a procedure in which a thin probe is placed near one of these small sensory nerve branches, usually with imaging guidance, and radiofrequency energy is delivered through the tip. The energy creates heat that interrupts the ability of that nerve branch to transmit signals. The joint itself is not opened and the structure of the joint is not altered.

Because the target is a sensory nerve branch rather than the joint surface, the procedure is aimed at pain signalling and not at the underlying condition. It does not repair cartilage, correct alignment, or reverse arthritis, and small sensory nerves can regenerate over time. Whether it is appropriate depends entirely on the diagnosis and the individual.

Symptoms that often bring people in

• Persistent joint pain, often in the knee or hip, that limits walking or sleep
• Pain that has continued despite therapy, activity modification and other measures
• Pain in someone who is not a candidate for surgery, or who prefers to avoid it for now
• Pain that continues after a joint replacement without an identified mechanical cause
• A wish to understand what non-surgical options exist before making a larger decision

How it is evaluated

An evaluation starts with establishing where the pain is actually coming from. Dr. Wolfson will take a history, examine you, and review x-rays and any other imaging. Pain around a joint can arise from the joint itself, from surrounding tendons or bursae, from the spine, or from more than one source at once. Where a nerve-targeted approach is being considered, a diagnostic block is commonly used first: a small amount of local anesthetic is placed near the nerve branches in question to see whether interrupting them changes the pain.

Treatment options in general terms

Non-surgical care is usually explored first, and it can include several categories of measure.

• Physical therapy and rehabilitation. Work on strength, motion and mechanics around the affected joint.
• Bracing and activity modification. Changing how load is carried through a painful joint.
• Injection-based options. A range of injections that may be discussed depending on the condition and on what has already been tried.
• Nerve-targeted procedures. Techniques such as radiofrequency ablation that aim to interrupt pain signalling from a joint without operating on the joint.

Where pain and loss of function continue and the structural problem warrants it, surgical options may be discussed.

• Joint preserving or arthroscopic procedures. Aimed at a specific mechanical problem inside or around the joint.
• Joint replacement. Considered for advanced joint damage when other measures have not achieved what the patient needs.

What to expect when you consult Dr. Wolfson

Dr. Wolfson, MD, FRCSC, FACS, is board certified in the United States and Canada, and he explores non-surgical treatment wherever it is reasonable. At a consultation he will work through where your pain is coming from before discussing any procedure, review your imaging with you, and explain the options that apply to your situation, including what each can and cannot be expected to address.

This page provides general information about radiofrequency ablation and is not medical advice. It is not a substitute for examination, imaging and diagnosis by a qualified physician. Every case is different and requires individual evaluation. If you have severe pain, an obvious deformity, loss of function, fever, or an injury from a significant accident, seek medical care promptly.

Contact Dr. Wolfson if you would like to setup an appointment. If you are a new patient, please book all in-person appointments with Dr. Wolfson via telephone.

If you live outside of the San Francisco Bay Area, you can request a complimentary phone consultation with Dr. Wolfson to assess your case. Please call or e-mail us to set up your complimentary consultation.

Call: (415) 221-4400

E-mail: [email protected]