Radiofrequency Neurotomy

Radiofrequency Neurotomy (RFN), is a specialised, minimally invasive procedure that is used to provide intermediate to long-term pain relief from various types of chronic pains, such as knee pain, shoulder pain, neck and lower back pain.

Radiofrequency Neurotomy is available at the following X-Ray & Imaging locations

Radiofrequency treatment involves our interventional radiologist placing needles, under imaging guidance, directly onto the nerves that are causing pain as determined by previous test injections/medial branch blocks. Heat is produced at the tip of the needle and is used to treat the nerves. This interrupts the nerves sending signals to the brain, which can provide long-lasting pain reduction.

Your suitability for RFN will be determined by performing various tests. Spinal nerve blocks with local anaesthetic are generally performed on two separate occasions. These are called medial branch blocks.

A medial branch block is a diagnostic procedure performed to identify the source of back and neck pain.

Anaesthetic is injected onto small medial branch nerves which innervate to specific facet joints. 

A six-hour pain chart is recorded in the hours immediately after the injections.

If pain relief is experienced in the few hours following the injections, then the facet joint is determined to be the source of the pain. 

If the medial branch block is successful in the first instance, it will be performed a second time, for complete confirmation. 

In instances where medial branch block is unsuccessful, then this determines that the pain may be originating from another source, and further investigations will be carried out until the direct source has been confirmed.

We advise you not to drive for 8 hours following the procedure, so please take this into consideration when scheduling your appointment.

If you are taking blood thinning medications such as Warfarin, Xarelto or Aspirin, please let our staff know. You may need to reduce or cease this medication before the day of the procedure. Please consult with your referring health professional.

You will be escorted into the CT examination room and positioned appropriately for the procedure.

A diathermy pad is placed on the thigh and the injection site cleansed. 

Local anaesthetic will be administered around the nerve that is responsible for the pain. Once the nerve and area are anaesthetised, a fine needle is positioned using CT guidance in proximity to the nerve.

A thin probe is then passed through the needle, which is connected to a generator that results in radiofrequency energy passing through the probe, resulting in heating of the probe tip. The result of this heat is to destroy the targeted nerve and therefore disrupting the ability of the nerve to transmit pain signals. 

Finally, long-term local anaesthetic and cortisone are injected around the treated nerve to minimise discomfort which may arise following the treatment.

You will be able to walk freely after the procedure but are required to rest in the clinic for observation.

We ask that you do not drive for at least 8 hours after the procedure due to the lasting effects of local anaesthetic near spinal nerves.

Most spinal RFN procedures take about 45 minutes, while more peripheral procedures may take longer.

  • Your original referral or request form
  • Medicare and any Government concession pension or health care cards
  • Previous relevant imaging

Average response time is around nine months, but some patients have up to two years of good pain reduction or complete pain relief.

The nerves that have been treated will eventually grow back and when this happens the pain will probably return, at which time the procedure can be repeated without the need for more test procedures.

Risks include infection which may very rarely require antibiotics or hospital admission. Bleeding may occur at the entry site, or into deeper tissues causing bruising, but is rarely of any consequence. If you are taking anticoagulants including aspirin or warfarin, or any other medications used to thin the blood, the risk of bleeding is increased.