How long does radiofrequency ablation last?

Relief commonly lasts somewhere between six months and two years. The treated nerves gradually regrow, which is why the effect is long-lasting rather than permanent. When pain returns in the same pattern, the procedure can usually be repeated.

Why do I need a nerve block before radiofrequency ablation?

A diagnostic block temporarily numbs the specific nerves we would ablate. If numbing them relieves your pain, those nerves are carrying the signal and ablation is likely to help. If numbing them changes nothing, ablation would not have worked either — and you avoid an unnecessary procedure. Most insurers also require this confirmation.

Does radiofrequency ablation hurt?

The skin and deeper tissue are numbed first. Most patients describe pressure and a brief deep ache during the ablation itself. The procedure typically takes twenty to forty minutes depending on how many levels are treated.

Is radiofrequency ablation the same as surgery?

No. RFA is a percutaneous procedure performed through a needle with image guidance. There is no incision, no hardware, and no fusion. It does not change the structure of the spine or joint — it interrupts the nerves carrying the pain signal from it.

Is radiofrequency ablation covered by Medicare?

RFA is commonly covered by Medicare and commercial insurance when specific criteria are met, which usually include documented diagnostic block relief. Requirements vary by plan. Call (805) 557-7050 and we will verify your coverage before scheduling.

Radiofrequency Ablation (RFA) for Pain — Thousand Oaks, CA

Q: Can radiofrequency ablation be repeated?

Yes. Because the treated nerves regrow over time, RFA can generally be repeated when the same pain pattern returns, often at intervals of a year or more. Repeat procedures tend to work about as well as the first one when the original diagnosis was correct.

What RFA actually does

It interrupts a signal. It doesn't fix a structure.

Pain from a joint travels along small sensory nerves to the brain. Radiofrequency ablation uses heat delivered through a needle to interrupt those specific nerves, so the signal stops arriving. The arthritis in the joint is still there. What changes is whether you feel it.

That distinction is worth sitting with, because it explains both the appeal and the limits of the procedure. RFA can give someone their sleep, their walk, or their work back for a year or more without surgery, hardware, or daily medication. It cannot regrow cartilage or reverse degeneration, and it was never meant to.

You may also hear this called radiofrequency neurotomy, rhizotomy, or nerve ablation. They refer to the same family of procedure.

The two-step rule

The block isn't a formality. It's the whole decision.

Ablation is only as good as the target. So before we treat a nerve, we test it — by numbing it temporarily and seeing what happens to your pain.

Step One

Diagnostic Block

A small amount of local anesthetic is placed at the specific nerves we would ablate. It wears off within hours — that's intentional.

Takes only a few minutes
You track your pain for the rest of the day
Often repeated once to confirm the result

Step Two — only if step one worked

Radiofrequency Ablation

If numbing those nerves clearly relieved your pain, we treat them with radiofrequency heat for a much longer effect.

20–40 minutes depending on levels treated
Same-day outpatient, no incision
Benefit typically develops over 2–4 weeks

If the block doesn't help, we stop — and that's a good outcome.

It doesn't feel like one. After waiting weeks for an appointment and going through a procedure, being told "this isn't your answer" is deflating.

But consider the alternative: an ablation on nerves that were never the problem. You'd have gone through a longer procedure, waited a month for relief that was never coming, and still not known where your pain was actually from. A negative block costs you an afternoon and saves you all of that.

It also redirects the search. If the facet joints aren't the source, that's real information about what to examine next.

Where it's used

Four targets, four different conversations.

RFA isn't one procedure. Where the nerves are, and what pattern of pain points to them, differs by site.

Lumbar Facet Joints

Pain patternLow back pain worse with standing, extending, or twisting; often better sitting

NervesMedial branch nerves

Cervical Facet Joints

Pain patternNeck pain and headaches starting at the base of the skull, worse with rotation

NervesCervical medial branch nerves

Sacroiliac (SI) Joint

Pain patternPain low and off to one side, often over the buttock; worse rising from sitting

NervesLateral branch nerves

Knee

Pain patternPersistent arthritic knee pain — including in patients who aren't surgical candidates, or who still hurt after replacement

NervesGenicular nerves

Longer than a block, shorter than you're imagining.

1

Before you come in

Blood thinners, blood sugar, and a driver

We give you specific instructions about any blood-thinning medication — never stop one on your own. You'll need someone to drive you home. Eat lightly beforehand unless we've told you otherwise.

2

In the room · 20–40 minutes

Positioning, numbing, testing, then treating

You lie on your front or back depending on the target. The skin and deeper tissue are numbed. Using image guidance, needles are positioned at the nerves, and a brief electrical test confirms placement — you may feel a tingle or a muscle twitch, which is expected and tells us we're in the right place. Then the radiofrequency current is applied, usually for a minute or so per site.

3

The first few days

It often feels worse before it feels better

Soreness at the treated sites is common and can last one to two weeks. Some patients get a temporary flare of their usual pain. This is the single most misunderstood part of RFA — patients assume it failed. Ice, gentle movement, and patience are the right response.

4

2 to 4 weeks

The real result arrives

As the treated nerves stop transmitting and the procedural soreness settles, the actual benefit becomes clear. Judging RFA before this point tells you almost nothing.

5

Follow-up

We measure it, and we plan the next window

We check what changed — pain, sleep, what you can do again. If it worked well, this is also the moment to use the window: strengthening done during a low-pain period is what makes the next year better, not just this one.

How long it lasts

Six months to two years — and then the nerves grow back.

That last part surprises people, so we say it early. The treated nerves regenerate over time. This is why RFA is described as long-lasting rather than permanent, and it's also why the procedure is repeatable — when the same pain pattern returns, we can generally treat again, with results that tend to hold up about as well as the first time.

The range is wide because patients are different. Some get eight months, some get two years, and a minority get little benefit despite a positive block. We won't tell you a number we can't stand behind — but we will tell you what we've seen in situations like yours.

What you do during the window matters more than most patients are told. A year of reduced pain spent building strength and mobility puts you in a different position when the nerves return than a year spent resting.

When it's not the answer

RFA is specific. That's its strength and its boundary.

Not for radiating nerve pain

Shooting pain down the leg or arm usually comes from a compressed nerve root, not a facet joint. RFA of the medial branches won't reach it. That's a different problem.

Not without a positive block

No diagnostic confirmation, no ablation. This isn't insurance bureaucracy — it's the difference between treating a target and guessing at one.

It doesn't treat the arthritis

The joint changes remain. RFA removes the alarm, not the cause — which is exactly why strengthening during the relief window matters.

Limited help for widespread pain

When pain is diffuse rather than localized, or the nervous system has become broadly sensitized, targeting one set of nerves rarely resolves it. A different approach applies.

Not a substitute for surgery when surgery is indicated

If there's progressive weakness, instability, or a structural problem that needs fixing, RFA is not the right tool and we'll say so.

Some patients simply don't respond

Even with a clearly positive block, a minority get little benefit. We don't know in advance who. You deserve to hear that before, not after.

Common questions

What patients ask about RFA

Why do I need a nerve block first?

Because it answers the only question that matters: are these the nerves carrying your pain? Numbing them temporarily tells us. If your pain drops substantially for a few hours, ablation is likely to help. If nothing changes, ablation wouldn't have helped either — and you've avoided a longer procedure for nothing. Most insurers require this confirmation as well, often twice.

Does it hurt?

The area is numbed first. During the ablation most patients describe pressure and a deep, brief ache rather than sharp pain. The electrical testing beforehand can cause a tingle or a muscle twitch, which is expected. Afterward, soreness at the treated sites for one to two weeks is normal.

Is this surgery?

No. RFA is performed through a needle with image guidance — no incision, no hardware, no fusion, nothing left behind. It's a same-day outpatient procedure, and you go home afterward with a driver.

Why did my pain get worse after the procedure?

A temporary flare in the first one to two weeks is common and does not predict the final result. The treated tissue is irritated, and the nerves take time to stop transmitting. The benefit typically emerges between two and four weeks. Judging the outcome in week one is the most common mistake — call us if you're worried, but don't conclude it failed.

Can it be repeated?

Yes. Because the treated nerves regrow, RFA can generally be repeated when the same pain pattern returns — often at intervals of a year or more. Repeat procedures usually work about as well as the first, assuming the original diagnosis was right. A repeat block may be required first, depending on your insurer.

Will the nerves being destroyed cause weakness or numbness?

The nerves targeted in RFA are small sensory branches that carry pain signals from a joint — they're not the nerves that control strength or sensation in your limbs. Some patients notice a patch of altered sensation over the treated area, and a small number notice temporary local muscle soreness. Significant weakness is not an expected outcome, and we'll review the specific risks for your procedure beforehand.

Is RFA covered by Medicare or insurance?

RFA is commonly covered when specific criteria are met, which almost always include documented relief from diagnostic blocks. Some plans require two separate positive blocks, and some require prior authorization. Call (805) 557-7050 and we'll verify exactly what your plan requires before anything is scheduled.

What if RFA doesn't work for me?

Then we reassess rather than repeat. A positive block followed by a disappointing ablation is uncommon but real, and it usually means either the technique needs adjusting or something else is contributing to your pain. We'll tell you honestly which we think it is, and what we'd do next.

Wondering whether your pain is coming from a facet joint?

That's the question an evaluation answers. Call and we'll examine you, review your imaging in context, and tell you whether a diagnostic block is the right next step — or whether something else should come first.

(805) 557-7050

Radiofrequency ablation carries risks including bleeding, infection, nerve irritation, temporary increased pain, and altered sensation over the treated area — and results vary between patients. This page is general education, not medical advice for your situation. Before proceeding you are entitled to a clear explanation of the risks, the alternatives, and what happens if you choose to do nothing, and you are always welcome to seek a second opinion.

We don't offer this until we've proven it will work.