Radiofrequency Ablation

If back or neck pain has hung on for months and injections or physical therapy only helped for a while, radiofrequency ablation (RFA) may be the next step. Our pain physicians perform RFA across Long Island and northern New Jersey — with offices in Plainview, New Hyde Park, and Ronkonkoma, NY, and Clifton, Montville, and Plainfield, NJ.

What radiofrequency ablation actually treats

Most RFA in a pain practice targets facet joint pain — pain from the small paired joints running up the back of your spine. When those joints become arthritic or irritated, tiny nerves called the medial branch nerves carry the pain signal to your brain. RFA uses radiofrequency energy to heat and interrupt those specific nerves, so the signal no longer gets through.

It’s commonly used for chronic pain in the lower back and neck that hasn’t responded to at least a few months of conservative care — medication, physical therapy, and injections. It is not a first step, and it isn’t for every kind of back pain. Pain that radiates down the leg from a herniated disc, for example, is usually a different problem with a different fix.

Are you a candidate?

The honest answer depends on a test. Before recommending RFA, your physician will usually perform a diagnostic medial branch block — a numbing injection at the same nerves RFA would target. If that block gives you strong, if temporary, relief, it’s good evidence the facet joints are the source of your pain and that RFA is likely to help. If it doesn’t, RFA probably isn’t your answer, and we’ll say so rather than proceed.

RFA tends to fit when:

• Your pain is mainly in the back or neck itself, not shooting down a limb
• It’s lasted several months despite conservative treatment
• A diagnostic block gave you meaningful, temporary relief
• You’d rather avoid long-term pain medication or surgery

What to expect during and after

RFA is done in-office, on an outpatient basis, using live X-ray guidance to place the needle precisely. Most procedures take roughly 20 to 45 minutes depending on how many nerves are treated. You’re awake but comfortable, and you go home the same day — you’ll just need someone to drive you.

Afterward, it’s normal for the area to feel sore for a week or so as the treated nerves settle. Pain relief isn’t always immediate; many people notice it build over the following two to six weeks.

How long does the relief last?

For most people, six months to a year. Some get considerably longer — one to two years or more — while others get less. The variation is real, and no honest practice can promise you a specific number. What we can tell you is that RFA generally provides longer relief than a steroid injection, which is a large part of why it’s worth considering when injections keep wearing off.

Why patients across Long Island and North Jersey choose Empire

Insurance

Coverage varies by plan and by location, and we accept many major insurance plans across our New York and New Jersey offices. The simplest way to know exactly what your plan covers is to call — our team will verify your benefits before your visit, so there are no surprises. Whether you’re on Long Island or in North Jersey, reach out and we’ll walk you through your options.

Frequently asked questions

How long does it take to recover from radiofrequency ablation?

Most people return to normal activity within a day or two, avoiding strenuous activity for the first 24–48 hours. The treated area can stay sore for about a week while the nerves settle.

Is radiofrequency ablation painful?

During the procedure you’re numbed and kept comfortable, and it’s usually well tolerated. Afterward, expect temporary soreness at the site for several days — an ice pack helps.

Are you awake during the procedure?

Usually yes. RFA is typically done with local anesthetic while you’re awake but relaxed, which lets your physician confirm the correct nerves are being treated. You’ll still need a ride home.

Is radiofrequency ablation considered surgery?

No. It’s a minimally invasive, nonsurgical procedure done through a needle under X-ray guidance — no incision and no stitches.

What’s the downside of radiofrequency ablation?

The relief is temporary because nerves regrow, so the procedure may need repeating. There’s also short-term soreness, and a small risk of the usual needle-procedure complications, which your physician will review with you.

What if radiofrequency ablation doesn’t work for me?

It doesn’t work for everyone, which is exactly why the diagnostic block comes first — to improve the odds before you commit. If RFA isn’t the answer, we’ll walk you through other options rather than repeat something that didn’t help.