Nerve ablation, most commonly performed as radiofrequency ablation (RFA), is a procedure designed to manage chronic pain by intentionally interrupting the transmission of pain signals. This minimally invasive technique uses a specialized needle and radiofrequency energy to create a heat lesion on a targeted nerve, blocking its ability to send pain messages to the brain. People considering this treatment often want to know what the experience of pain will be like during the procedure and afterward.
Pain During the Procedure
Patient comfort is a primary focus during nerve ablation, and the procedure is typically performed while the patient is awake to allow for feedback. Before the main needle is inserted, a local anesthetic is injected to numb the skin and the deeper tissues along the needle’s path. This significantly reduces the sensation of pain, though the initial injection can feel like a brief, sharp pinch or sting.
Once the needle is near the target nerve, the physician performs a stimulation test by sending a mild electrical current through the needle. This safety step confirms the needle’s precise position and ensures it is not too close to a motor nerve that controls movement. Patients usually feel a tingling, buzzing, or twitching sensation during this test, but not sharp pain. If needed, a light sedative may also be given to help the patient relax throughout the process.
When the actual heat lesion is created, the local anesthetic injected around the nerve prevents the patient from feeling a burning sensation. Instead, patients may feel a deep pressure or a dull ache in the treated area. The entire ablation process involves heating the nerve for about 60 to 90 seconds per site and is generally well-tolerated due to these anesthetic measures.
Expected Post-Procedure Discomfort
After the nerve ablation is complete and the local anesthetic begins to wear off, it is common to experience some discomfort at the injection site. This post-procedural pain is distinct from the chronic pain the treatment addresses and is usually felt as soreness, tenderness, or bruising. This localized discomfort typically subsides within a few days.
A temporary nerve flare-up, known as neuritis, can also occur as the treated nerve reacts to the thermal injury. This irritation can cause a temporary increase in pain or a sensation similar to a sunburn in the area served by the nerve. This pain flare often peaks within the first 24 to 48 hours and may last for one to two weeks while the nerve settles down. Physicians often recommend applying ice to the injection site and using over-the-counter pain medication to manage this expected recovery discomfort.
How Nerve Ablation Stops Pain Signals
The goal of radiofrequency ablation is to create a controlled injury that disrupts the pain communication pathway. The radiofrequency energy generates heat, typically raising the nerve tissue temperature to about 80 to 90 degrees Celsius. This focused heat application creates a small, precise lesion on the targeted sensory nerve.
This heat lesion causes the structural proteins within the nerve’s axon to denature, effectively destroying the portion of the nerve responsible for electrical signaling. By disrupting the nerve’s structure, the procedure prevents it from transmitting pain signals to the spinal cord and then to the brain. The sensory nerves that carry the pain signal are disabled, while the surrounding motor nerves are typically left unharmed.
This interruption of the signal pathway is the mechanism by which pain relief is achieved, often leading to a noticeable reduction in chronic pain. However, it can take anywhere from a few days to up to three weeks for the full effect of the procedure to be felt. This delay occurs because the damaged nerve tissue needs time to fully degenerate and stop all transmission of signals.
Variability of Pain Relief
The amount and duration of pain relief following nerve ablation can vary significantly among individuals. For many people, the procedure offers substantial relief, often meeting the clinical goal of a 50 percent or greater reduction in pain. This relief typically lasts between six and 12 months, though some patients experience benefits for a few years.
The treated nerve tissue does eventually attempt to regenerate, which is why the pain relief is not permanent. If the nerve regrows, it may start sending pain signals again, usually resulting in the recurrence of the original pain after about 6 to 18 months. If the procedure was successful the first time, it can often be repeated when the pain returns. In rare cases, a patient may experience increased or new nerve-related pain, known as neuropathic pain, following the procedure. If severe pain persists or worsens over time, or if signs of infection like fever or increased redness appear, patients should contact their physician immediately.