Depending upon the areas to be treated, the procedure can take from about twenty minutes to an hour.

A small needle known as a radiofrequency cannula is positioned next to the targeted nerves using ultrasound or fluoroscopic guidance (a type of real-time X-ray). Once the needle is in place, small electrical stimulation is used to double check needle placement. This stimulation may produce a buzzing or tingling or pressure sensation or you may feel your muscles in the area jump. Once the proper placement of the cannula is confirmed, a local anesthetic (“freezing”) is injected to numb the area to minimize the discomfort. Then an electronic current is passed using the Radiofrequency machine and the nerves are heated up to approximately 80 degrees Celsius for about one to two minutes. This “numbs” the nerves semi-permanently. The cannula is then removed, and the procedure is complete. 

The procedure can be done either with the patient lying on the stomach, back or a side position depending on the procedure. The patients are monitored with blood pressure cuff, and blood oxygen-monitoring device. The skin over the target area is cleaned with antiseptic solution and then the procedure is carried out.

No. This procedure is generally done under local anesthesia. Only in some exceptional cases oral sedation may be given. 

Please do not eat any solid foods up to 6 hours before your procedure time. You can drink clear fluids like clear apple juice, black tea, black coffee or water up to 1 hour before your procedure. Please arrange for a ride home after the procedure, even if you do not have sedation. It is OK to take your medications with a sip of water with either decision.

Nerves are protected by layers of muscle and soft tissues. The procedure involves inserting a needle through skin and those layers of muscle and soft tissues, so there is some discomfort involved. However, we numb the skin and deeper tissues with a local anesthetic using a very thin needle prior to inserting the RF cannula. There may be moderate discomfort (a flare of pain) in the affected area for a few weeks after the procedure. You may have numb areas with increased sensitivity (like a deep sunburn). 

Initially there will be muscle soreness for up to a week to a few weeks afterward. Ice packs or Tylenol or ibuprofen will usually control this discomfort. After the first two weeks are over, your pain may be gone or quite less. Some patients may have some “deep sunburn” type feeling. Some may develop hypersensitivity or burning pain or numb areas for a few weeks. 

After lesioning of the 3rd Occipital nerve (for headaches), some of the patients may develop dizziness or vertigo for a few days. The relief of pain may be noticed only after about 2 to 3 weeks, not necessarily right away.

We ask that you someone is available to take you home. We advise the patients to take it easy for a day or so after the procedure. You may want to apply ice to the affected area. Perform normal daily activities as tolerated by you.

You should be able to return to your work the next day. Sometimes soreness at the injection site causes you to be off work for a day or two. 

Results are generally noticed by patients within two to four weeks depending on the amount of time it takes your body to heal. On average, RFL provides six months to two years reduction/elimination of pain, but it really varies from patient to patient.

If the first procedure does not relieve your symptoms completely, you may be recommended to have a repeat procedure after re-evaluation. Because these are not permanent procedures, they may need to be repeated when the numbness wears off (often 6-12 months) 

The following patients should not have this injection:

• if you are allergic to any of the medications to be injected
• if you are on a blood-thinning medication (e.g. Coumadin, Plavix)
• if you have an active infection
• if you have not responded to local anesthetic blocks, you may not be a candidate for this procedure.

RFL is considered a safe procedure, and great care is taken when placing the radiofrequency needle (cannula). However, with any procedure there are risks, side effects, and the possibility of complications. The risks and complications are dependent upon the sites that are targeted. Some possible complications are allergic reaction to the local anesthetic used, infection, soreness, bleeding and muscle spasms. A rare side effect is damage of other nerves and blood vessels close to the targeted nerve leading to permanent altered sensations including numbness, burning, tingling, and possibly extremity weakness. Please discuss your specific concerns with your physician.