Unlike a steroid injection that can sometimes give relief in a day or two, RFA often has a different timeline. Many patients experience 1-2 weeks of post- procedure soreness (which we often call a “post-ablative flare”). After that subsides, the real pain relief kicks in. So usually by 2 to 3 weeks out, you notice significant improvement compared to before the procedure. Some do feel better sooner, especially if the procedure itself broke the pain cycle. But plan for a short-term increase in achiness that will transition to relief. We’ll give you instructions to manage that interim period. If by a month you don’t notice improvement, we’d evaluate further, as most should feel better by then if it’s going to work.

Typically, yes, as the nerve regenerates, it can resume carrying pain signals from that joint or area if the underlying cause (like arthritis) is still there. However, the timeline is variable – often 6-18 months of relief is quoted. We’ve seen some patients go 2+ years without significant return of pain. And if/when pain does return, the RFA can be repeated. In some fortunate cases, patients have long-term improvement even beyond nerve regrowth possibly because they used the pain-free window to improve their condition (e.g., strengthen core muscles, improve posture, thus lessening stress on the joint).

But generally, you should anticipate that pain may gradually creep back and when it does, we can assess and likely do the procedure again if appropriate. Repeating RFA usually yields similar results each time.

There isn’t a strict limit, as the radiofrequency waves are localized and don’t have cumulative body effects like steroids would. If pain recurs in, say, a year, we can repeat it. Some patients have RFA done periodically for chronic conditions. 

The main consideration is that repeatedly ablating nerves that supply a joint might in theory affect stability or proprioception subtly (there’s some debate, but generally not a big issue). For example, in the neck, the facet nerves also supply tiny muscles; repeated RFA might weaken those muscles slightly. But clinically this isn’t a major concern we see often. 

So, practically, you can repeat as needed; we will also monitor how your underlying condition is – if it’s worsening, sometimes surgical interventions could be considered as an alternative. But if RFA works well, it’s fine to use it multiple times over the years.

We prevent you from feeling the “burn” by numbing the area thoroughly with local anesthetic before we lesion the nerve. The process is carefully controlled. You may feel some pressure or a dull ache during the heating, but you should not feel intense pain. 

Our patients often say the worst part was the initial numbing needle pinch. If at any point you feel sharp pain, you let us know and we adjust. Post-procedure, as mentioned, the area can feel sore or like a sunburn internally – that can be managed with over-the-counter pain meds or a short course of medications we can prescribe if needed. We want the experience to be as comfortable as possible.

Nerve blocks (like medial branch blocks) use a numbing medicine (and sometimes steroid) to temporarily relieve pain. They’re diagnostic and short-term therapeutic. Relief from a block usually lasts hours to a couple days if a steroid is added. RFA, on the other hand, actually disrupts the nerve’s function for a longer period by creating a lesion. 

Think of blocks as a “preview” and RFA as the “main show” for longer relief. We don’t jump straight to RFA without blocks because we want to be sure we’re targeting the right nerve. Blocks are also less destructive – which is good as a test, but for lasting relief, RFA is preferable. Repeating blocks frequently would require constant visits and exposure to meds; RFA gives a break from that by providing sustained relief.