Nerve block and radiofrequency ablation for pain management

You and your anesthesiologist and pain team have decided to manage your pain through blocking the nerves, This treatment consists of one or multiple test blocks and one definite block. You will receive your treatment at the Diagnostics and Treatment Center (onderzoek- en behandelcentrum; OBC). You can eat and drink as usual before your treatment and can take your medication as usual.

Important information

Please let us know if you are taking blood thinners. You may need to quit taking this medication several days before the procedure. Certain painkillers can affect blood coagulation. Please consult your physician about your painkillers. If you have any sensitivities to iodine, bandages, contrast agents or anesthesia, please consult your pain specialist. X-radiation may harm an unborn child. If you are pregnant or suspect you may be, please let us know before the start of the treatment.

Purpose of the treatment

The treatment aims to interrupt the transmission of pain signals to the brain. To determine which nerves transmit the pain signals, your physician will temporarily numb a number of nerves by approaching them with a small needle with the aid of x-ray imaging, and delivering a sedative that will temporarily block the nerves. You may need to have several nerves blocked before the correct placement for a permanent block has been found.

Tracking pain intensity

We will ask you to track the intensity of your pain for 24 hours following the procedure, using a protocol. If the pain disappears for at least two hours following a test block, your physician can use radiofrequency to block the nerves off permanently during your next visit.

Pulsed radiofrequency

By using pulsed radiofrequency (PRF), your nerves can be blocked off, interrupting the transmission of pain signals. Only those parts of the nerves that transmit the pain signals are affected by the treatment: you will be able to feel and move as usual.

You will receive a local anesthetic during the procedure, which may cause skin numbness or muscle weakness directly after the procedure, similar to your experiences with test blocks.

The treatment

You will lie on your back or stomach on the x-ray table, depending on the location of the block. Your skin will be disinfected and numbed around the area of insertion, after which x-radiation will aid the placement of the needle close to the nerve.

Test block

If you are receiving a test block, the position of the needle will be determined by using a radiocontrast agent. The numbing agent will be administered directly after, and the needle will be removed.

PRF treatment

When receiving PRF treatment, your physician will first use electric current to determine the correct position for the needle. Once he or she is certain that the position is right, all nerves that transmit pain signals will be blocked using an electromagnetic field. You will not feel much of the procedure other than some minor pulsing at the start of the treatment, which may be unpleasant . The procedure will take several minutes to complete. Please make sure that you do not move or speak during the session, as this could alter the location of the electrode.

Risks

Risks are inherent to medical treatment. Test block or permanent block procedures rarely cause unwanted damage.

Guidance

The insertion of the electrode may hurt. The pain may linger for several days, but will eventually fade. The numbing agent may cause muscle weakness or numbing. Please make sure that you bring someone with you who can take you home, and do not drive.

Problems after permanent block

You may experience pain symptoms for several days following the procedure, so please continue taking your regular pain medication for a few more days. Once the pain has faded, you can consult your doctor about decreasing your medication.