Radiofrequency for low back pain: who it is for and how long it lasts
Radiofrequency is a procedure for chronic low back pain originating in the facet joints, the small joints at the back of the spine. It uses controlled heat to interrupt the nerve that carries pain from these joints and can provide relief for several months, making rehabilitation possible with less pain.
Who it is for
low back pain for more than three months, mainly in the centre or on one side of the spine;
pain that worsens when arching the back, twisting or after standing for a long time;
not enough improvement with well-delivered exercise and physiotherapy;
clear but temporary relief from a diagnostic medial branch block.
It is not the right treatment for pain travelling down the leg due to a compressed nerve root; in those cases there are other options, such as an epidural injection.
How the process works
Pain medicine consultation: a clinical examination to understand where the pain comes from and whether radiofrequency makes sense.
Diagnostic block: an anaesthetic injection next to the nerves of the suspected joints. If the pain clearly eases over the following hours, the source is confirmed.
Radiofrequency: under local anaesthetic and image guidance, a special needle applies heat to the medial branches. It is an outpatient procedure and you go home the same day.
Rehabilitation: with less pain, it's time to strengthen the muscles that stabilise the spine with physiotherapy.
Radiofrequency is one of the image-guided procedures performed at Clínica Myalgia, always as part of a treatment plan that includes exercise and medical follow-up.
What to expect
The effect is usually felt after two to three weeks and can last from several months to more than a year, as the nerves eventually regenerate. If the pain returns, the procedure can be repeated. Side effects are uncommon and usually mild, such as local pain in the first few days.
Find out more about the causes and treatment of low back pain.
Conventional and pulsed radiofrequency
Conventional (ablative) radiofrequency: heats the nerve enough to interrupt pain transmission. It is the most widely used for lumbar and cervical facet joints.
Pulsed radiofrequency: applies the current in pulses, without destroying the nerve. It is used, for example, on nerve roots and some peripheral nerves.
Risks and aftercare
As with any needle procedure, there is a small risk of bleeding or infection. There may be local pain or temporary changes in skin sensation. It is important to tell your doctor if you take anticoagulants or have allergies. After the procedure, relative rest on the day and a gradual return to activity are recommended.
Frequently asked questions about radiofrequency
Does radiofrequency hurt?
It is done under local anaesthetic. There may be some discomfort during the procedure and local pain over the following days.
How long does the effect last?
It varies from person to person: generally from several months to more than a year.
Can I work the next day?
In most cases yes, for jobs without heavy physical effort. Your doctor will tell you when to resume exercise.
Does radiofrequency replace surgery?
They treat different problems. Radiofrequency treats facet joint pain; surgery is for situations such as severe nerve compression or instability.
Dr. Miguel Reis e Silva
Doctor at Sport Lisboa e Benfica
Medical Director and Founder of Clínica Myalgia
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