Radiofrequency Ablation (RFA) Side Effects and Risks

Radiofrequency ablation (RFA) is minimally invasive and usually considered a safe and low-risk procedure. However, as with any injection procedure, there is always a chance of developing side effects or other complications.

Side Effects of Radiofrequency Ablation in the Facet and Sacroiliac Joints

Immediately after radiofrequency ablation, the following side effects may be experienced:

• Burning and/or hypersensitivity over the injection site
• Numbness and/or tingling over the injection site

Sometimes, these symptoms may feel like a sunburn in the treated area. While these symptoms may last for the first few days or weeks, they can be managed by resting, intermittently using an ice-pack over the sore area, and using topical or oral medications.

Watch Video: How to Make 5 Quick and Easy Ice Packs

These symptoms are typically not severe, however, sometimes the pain may be troublesome and may last for several weeks. While these symptoms are less common in the mid and low back, they may be more common at higher levels of the neck.¹Stolzenberg D, Gordin V, Vorobeychik Y. Incidence of neuropathic pain after cooled radiofrequency ablation of sacral lateral branch nerves. Pain Med. 2014;15(11):1857–60. These side effects may be due to increased irritation of a nerve that was only partially damaged and may still possess some function.

The medial branch nerves control some small muscles in the neck and mid or low back, but the loss of these nerves usually does not cause any significant loss of motor function. The lateral branch nerves do not control any muscles or sensation in the arms or legs, so a heat lesion poses less danger of negatively affecting those areas.

There may be a concern that without the ability to feel sensation through the treated nerves, an injury to either the neck or back may be caused. There is, however, no scientific evidence to support this concern. In fact, in the many years that neurotomies have been performed, patients have not been found to be at an increased risk of injury.

Risks of Radiofrequency Ablation in the Facet and Sacroiliac Joints

Although rare, serious risks may occur during or after the radiofrequency ablation procedure. These risks may be associated with the RFA procedure or the sedation provided prior to the treatment.

• Radiofrequency ablation procedure-related risks. A few examples of risks associated with the RFA procedure are:
  • Hyperesthesia—an excessive, abnormal sensitivity over the skin of the injection site
  • Superficial skin infections over the injection site
  • Damage to surrounding blood vessels and nerves during needle insertion resulting in excessive bleeding and/or irreversible neurologic damage causing long-term numbness and tingling
  • Heat damage to structures adjacent to the target nerve
  • Allergic reaction to the anesthetic used to numb the skin

  Apart from these risks, muscular tissue damage and itching at the injection site may occur in some cases.

• Sedation-related risks. Although the use of sedation is rare, mild to moderate sedation or general anesthesia may be used during the RFA procedure in some cases. Allergic reactions and respiratory depression (breathing difficulty) may result from the sedation process in rare cases.

As with any injection procedure, treating a facet or sacroiliac joint with radiofrequency ablation must involve careful consideration of benefits versus risks. It is advisable to discuss and understand the potential risks of radiofrequency ablation with a doctor before opting for this treatment method.