Radiofrequency Back Pain Treatment Reviews: Is This a Good Idea?

By Chris Centeno, MD /

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radiofrequency back pain treatment review

Radiofrequency has recently resurfaced in the medical news, but are there any reliable Radiofrequency Back Pain Treatment reviews?  Many years ago, I learned how to use radiofrequency ablation (RFA). The good news is that, for the first time, I could treat patients with chronic neck pain and they would get better for one to two years from a single treatment. The bad news is that I knew I was destroying tissue to do it and that this would eventually come back to haunt the patient. Now a new low-back-disc RFA device has just received FDA approval, and that’s a problem as my patients will now be getting the same destructive procedure believing that this is helping their disc, when in fact the opposite is likely occurring.

What Is RFA?

Radiofrequency ablation isn’t new—in fact it’s been performed for many years in pain management. Basically, it uses energy in the radiofrequency spectrum to heat tissue and ablate (read “destroy”) tissue. This is one of those times in medicine when if we doctors named these devices for what they did, you as a patient would never sign up. For example, who wants to be treated with a “radiofrequency destruction device.” So to fix that problem, we substituted another, more obtuse, word like “ablation.” Most patients aren’t quite sure what that means, and even if they do know what it means, it sounds oh so much more elegant than “destroy.”

The Upsides and Downsides of RFA

When I first learned how to use RFA to treat chronic neck pain due to damaged facet joints in the neck, it was a pretty neat tool to have. I could treat my patients’ neck pain once and they would get one to two years of relief. Of course the pain would come back with a vengeance, and they would need another treatment, but at the time, this was pretty revolutionary.

The downside of RFA is that we’re destroying tissue. In the case of the neck, that tissue is the little nerve that takes pain signals from the joint. We know from other areas of medicine that when you take away a nerve supply to a joint, bad things happen. Eventually, since the patient can’t feel the area and continues to place forces on the damaged area, the pace of arthritis of that joint quickens. This is called a Charcot joint.

What’s fascinating in RFA is that, at least in the neck, I still can’t find a single study where someone has looked at this issue long-term (i.e., what happens to the neck joints of long-term-treated RFA patients). Maybe we as pain-medicine doctors just don’t want to know. I can tell you that in my own patient population, I saw these joints get worse over time, but that’s just my observation. Given that almost all of our chronic spine patients who were getting RFA have now been switched to platelet or stem-cell-based treatments, it’s a question I’ll never be able to definitively answer.

Radiofrequency Back Pain Treatment Reviews: RFA of the Low-Back Disc?

I recently read a press release about a new low-back-disc-pain RFA treatment. The orthopedic surgeon who participated in the study had glowing reviews of the technology, and a few patient successes were highlighted. The procedure received FDA approval, and as a result, I’m sure that I’ll begin seeing patients now at my clinic who have had the procedure.

The problem with Radiofrequency for low-back discs is of course the same problem as the one I describe above—destroying the nerves in the disc is no safer in the long run than destroying the nerves that take pain from the neck or back joints. Those nerves serve a purpose. In the case of a painful disc, they help get weight and forces off the disc until it can heal. So should we be nuking those nerves and likely causing faster degeneration of the disc, or should we be using treatments that might help the disc, like platelets and stem cells? You already know which one I’m going to offer my patients.

The upshot? Radiofrequency Back Pain Treatment reviews are not good. RFA was a great technology for its time that helped patients in the short run and likely hurt them in the long run. However, with all of the new platelet and stem-cell-based options for the spine, it seems like this new RFA disc treatment has arrived very late to the party. No thanks for me. I’ve stopped nuking important nerves in my patients to buy them some relief—gave it up for good!

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25 thoughts on “Radiofrequency Back Pain Treatment Reviews: Is This a Good Idea?

  1. Annette Brunken

    Dr. Centeno, thank you on this topic. Where do you stand on the topic of at home Level 3 Cold lasers? Is it the same principal, apply light and get cells to attract White blood cells to do the repair, but over time there is a downside? Or are these 2 completely different technologies?

    I have a unit at home. Have had Regenexx-C and SD (Hip OA), and wonder if/how I should be using the cold laser.

    I read your blogs daily and have for almost 2 years, thank you!!

    1. Regenexx Team Post author

      Annette,
      Glad you enjoy it! We recommend Infrared Heat Therapy and they are 2 different technologies, but will inquire about the use of the Level 3 Cold laser for you.

    2. Regenexx Team Post author

      Annette,

      I have received an answer to my inquiry about the Cold Laser therapy, and while we recommend the Infrared Units, the Cold Laser therapy would be fine.

  2. Rick

    RFA has helped reduced my chronic low back pain from a pain level 9/10 to a 6 or 7. I reluctantly did it after years of alternative/integrative treatments including diet, good posture, exercise, massage, prolo, PRP, etc. I’m still getting the PRP/prolo and hoping there’s more improvement since my back isn’t so inflamed. Sometimes the pain is that bad for so long that it’s almost necessary to consider treatments/medications to get a handle on the endless pain. Other then narcotics and surgery I haven’t left much else on the table.
    I’m a believer in the PRP treatments and glad to see you guys researching it more each day.

    1. Regenexx Team Post author

      Rick,
      Glad for the movement from the 9 to a 6 or 7! The problem there is the treatment leads to faster degeneration of the disc because the nerves to protect it have been taken out of commission. We’d be glad to take a look to see if in your particular case, our toolbox can help. http://www.regenexx.com/the-regenexx-procedures/back-surgery-alternative/

  3. Michael

    Hello Dr. Centeno,

    What is your opinion of RFA (Coolief in particular) to resolve neuropathic pain resulting from ove- stimulation?

    Also, what is your opinion of RFA (Coolief in particular) to the articular branches of the femoral and obturator nerves assuming limited weight bearing (walking) during the healing process.

    Finally, I have you seen any long term studies on RFA and femoral head/cartilage degeneration?

    Thanks!
    Michael

    1. Regenexx Team Post author

      Michael,

      RFA kills nerves and the method is not important, the consequences are. Issues like you describe can often be treated with Platelet procedures, which are significantly less expensive than stem cells. Please see: https://regenexx.com/blog/athletic-pubalgia-surgery/

  4. Robert Levin

    Hi
    What is your opinion of a treatment called COOLIEF Cooled Radiofrequency? For back pain? Is this treatment basically the same as RF except using cold instead of heat?

    Do you have any knowledge of a treatment for groin pain caused by hernia surgery called ilioinguinal micro-cryoablation?

    I understand what you are saying which makes a lot of sense, but what is a person supposed to do that cannot afford stem cell treatments? Insurance will not pay?
    Thanks for that information you are putting out.
    Robert

    1. Regenexx Team Post author

      Thanks Robert! COOLIEF Radiofrequency does use heat, it’s just that it follows the heat with cold. The ilioinguinal micro-cryoablation procedure is also a denervation or ablation procedure. These procedures are widely used, but in our opinion, burnng nerves, or ablation is not a good idea as was covered in the blog. It might be worth it to go through the candidacy process, as you might find that Platelet procedures rather than stem cell procedures would be what’s needed in your case. Please see: https://regenexx.com/blog/neck-nerve-ablation/ and https://regenexx.com/the-regenexx-procedures/back-surgery-alternative/

  5. Stephanie Mooney

    What about Class IV laser treatment? And also PEMF. magnetic field.?

    1. Regenexx Team Post author

      Stephanie,
      Would not recommend either.

  6. Bobby Omari

    Hi Dr. Centeno, I’ve gone to pain management and my doctor tried the shots in my neck (steroids/lidocaine) and I experienced comfort for most the day then it came back… with a vengeance. They believe its a neurological problem so they want to do the injections again to prove it is a neurological problem and then do the RF treatment. Based on what you said, do you think this is the right choice? I am 26 years old and want to avoid anything that I might regret later, but I am in constant pain in my neck to a point where I am just taking painkillers and other medications constantly just to try to keep the pain manageable. Is there another procedure you would recommend?

    1. Regenexx Team Post author

      Bobby,
      The problem with steroid injections is that they are a net negative. While they can provide temporary pain relief, they actually damage the joint. Treatment with your own platelets or stem cells when needed has been very successful for cervical issues. If you have a recent MRI, you can submit the Candidate form so we can discuss whether you’d be a good Candidate for these procedures and what treatment would likely be best in your case. Please see: https://regenexx.com/blog/want-see-advanced-image-guided-injection-step-procedure-suite-dr-pitts/

  7. Mira

    Hi. My dad is 90 years old and has severe OA in both of his knees and neck and can barely walk due to the intense pain. My siblings and I have been trying to find something to help him and ran across the Coolief procedure. I did not realize that it involved the destruction of tissue, so thanks for explaining that. He also is dealing with prostate cancer, so he would not be a good candidate for stem cell treatment. What are your thoughts about any other alternatives we can research?

    1. Regenexx Team Post author

      Mira,
      So sorry to hear about all your Dad is dealing with. You’re correct that patients who have active cancer are not stem cell Candidates. Sometimes things like knee instability which not only causes arthritis, but aggravates it, can be treated enough to tighten up lax ligaments with just Prolotherapy. Please see: https://regenexx.com/blog/the-original-regenerative-medicine-technique-prolotherapy/ Let us know if you’d like to learn more…

  8. DeeDee

    Help! My 90 year old mother is having rf ablation on her lumbar spine tomorrow & I’m very nervous since I had 3 cervical levels done 4 years ago & had a very rough post surgery. Is it safe for her to have this done at her age? She’s had injections, prp & epidural with short lasting results. Pain mgmt doc seems confident but I’m afraid. I just found your page & I’m sorry for the last minute question but I’d appreciate your advice asap. Thx

    1. Regenexx Team Post author

      DeeDee,

      She might be better off trying PRP injections in the facet joints as this doesn’t burn any bridges like RFA does.

  9. Kimberly Freitas

    Hello, I am a 48yr old female with severe chronic back and neck pain. I’ve had a neck fusion and an anterior discectomy which was a failure. I’ve had Crohns for over 20 years and as a result I have degenerative disc disease and arthritis resulting in 14 different surgeries. But my back, neck and severe chronic migraines are my main source of pain. I have had so many different types of injections I can’t even name them all. I have my 5th RFA scheduled for Thurs Nov 30th, next week. During the last one I was told that it was approved to go deeper and more aggressive. I was down for about 3 weeks in massive pain with short term relief, mostly with the migrains. I am scared…I’m in tears everyday from pain and muscle spasms. I’m tired of taking all the pain pills, muscle relaxers etc. Do you think I am in jeopardy of having permanent damage to my nerves? I have have both lower back and cervical RFAs. What is another option for me? I can’t have an MRI due to an interstem for Crohns and OAB. Please, can you give me any advice?

    1. Regenexx Team Post author

      Kimberly,

      The concern is not just damage to the nerves – RFA’s purpose is to kill the nerves carrying the pain signal. Unfortunately, the nerves RFA kills also control important spinal stabilizers, so subsequent RFA procedures would create escalating instability, making the situation progressively worse. Without an MRI, we’d need to begin with the exam, to see if you’d be a Candidate for a procedure. These are the Doctors that can do the type of extensive needed. Please see: https://regenexx.com/blog/burn-nerves-in-low-back/ and https://regenexx.com/the-regenexx-procedures/back-surgery-alternative/ and https://regenexx.com/find-a-physician/

  10. Lori

    Hi,
    Two problems.
    My husband is 50 years old and set up to do cervical ablation and I’m worried reading what it does. The other option was stem cell but why is the Dr. suggesting ablation?
    Next problem. My 82 year old mom has done everything to help alleviate lower back pain and numbness in the leg-physical therapy, chiropractor, steroid shots, and now finally in butran patch and oxycodone 3x a day. We are out of options and contemplating surgery if her doctors approve. She is going to try medical marijuana but that doesn’t solve the problem. We have a current MRI. Please advise.

    1. Regenexx Team Post author

      Lori,
      Killing off nerves which stabilize the neck is not a good idea, especially since the problem can often be fixed without the irrevocable side effects. Not sure why ablation is the suggestion, but unfortunately, most Doctors would have a lot more training and experience in Ablation, than cervical interventional orthopedic injections. Steroid shots kill tissue, pain meds make pain worse in the long run. If you’d like to see if either issue would be a Candidate to solve the problem with their own platelets or stem cells, please submit the Candidate form. Please see: https://regenexx.com/blog/burn-nerves-in-low-back/ and https://regenexx.com/the-regenexx-procedures/back-surgery-alternative/

  11. ken Laukhuff

    I just read the article on RFA I had the treatment and now I am suffering from it. The last four needles out of 22 counting the 14 block the Doctor did a minute and a half when he started the last minute and a half he gave me a quick sharp electric jolt that made my body jump and then he turned it down I just about yelled at him to stop and he said you have a minute and 15 seconds to go I thought I can hang on that long. Now weeks later I have terrible pain on my left hip down to my knee cap my bones on the left side crack terrible every time I move it is horrible and I have so much pain I use a cane and walker. I am so lost I saw one Doctor he said I need a left hip replacement and knee replacement. Do you think this will be permanent damage.

    1. Regenexx Team Post author

      kent,
      We’d need to examine you to determine what’s going on.

  12. Michelle Heller

    Do you know if the stem cell or platelet procedures are covered by insurance or are they still considered experimental? I’m schedule for two RFA’sin the lower back later this month and am scared reading your reviews of the RFA procedure. My insurance’s United healthcare if you have any experience or knowledge whether they cover these types of procedures. I would also like to know if these are FDA approved procedures, both stem cell and platelets or are they still considered experimental?

    1. Regenexx Team Post author

      Michelle,
      We can’t advise on your case in paricular without examining you, but as a general principle, killing the nerves which stabilize the low back is not a good idea and has consequences. Regenexx procedures are covered by an ever increasing number of employer funded healthcare plans. Please see: https://regenexx.com/blog/regenexx-makes-sense-company/ and https://regenexx.com/blog/regenexx-partners-with-access-healthnet/
      https://regenexx.com/blog/regenexx-pulse-healthcare-announce-partnership-reduce-orthopedic-surgery-rates/ and https://regenexx.com/blog/connect-healthcare-collaboration-picks-regenexx-reduce-orthopedic-surgery-costs/ and https://regenexx.com/blog/regenexx-acap-fixing-broken-medical-care-system/ and https://regenexx.com/blog/regenexx-edison-health-mean/

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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