Thermolesion (radiofrequency ablation, RFA)

A natural solution for your spine!

What is thermolesion?

Thermolesion (radiofrequency ablation, RFA) is a medical procedure primarily used to treat chronic pain caused, among other factors, by compression of nerve roots.

It involves destroying a small portion of the painconducting nerve using radiofrequency energy, which heats the targeted tissue to approximately 80°C.

Thermolesion is minimally invasive and generally very well tolerated.

Complications are rare and typically temporary, such as mild injectionsite pain, numbness, or slight swelling.

The goal of the procedure is to reduce pain, improve mobility, and enhance the patient’s overall quality of life.

Before thermolesion is performed, the patient undergoes a thorough diagnostic process to confirm that the targeted nerves are indeed responsible for the pain.

This assessment includes:

  • Medical interview and physical examination – to evaluate the location, nature, and intensity of pain.
  • Imaging studies – most commonly MRI of the spine to rule out other causes of pain, such as a herniated disc or tumor.
  • Diagnostic nerve block – a key step in qualification. A small amount of anesthetic and antiinflammatory agent is injected into the suspected paingenerating nerve pathway.
  • If the pain disappears or significantly decreases for several hours, it confirms that the nerve is the source of symptoms.
  • Only then can the patient be qualified for thermolesion (RFA).
  • Laboratory tests – performed if recommended by the doctor.

Main indications for thermolesion

Facetjoint–related spinal pain

Pain in the cervical, thoracic, or lumbar spine associated with degeneration of the facet (zygapophyseal) joints.

Pain confirmed by a positive diagnostic nerve block.

Pain that worsens with movement, bending, or extending the spine.

Postoperative and posttraumatic pain

Chronic pain following orthopedic, neurosurgical, or thoracic surgery.

Pain localized to a postoperative scar.

Cancerrelated pain

In selected cases—such as localized, treatmentresistant pain that does not respond adequately to pharmacological therapy.

Effect of thermolesion

Thermolesion is designed to block the transmission of pain signals through specific nerves that are responsible for pain perception in a particular area of the body.

Although the procedure does not remove the underlying cause of the condition (e.g., degenerative changes), it eliminates or significantly reduces pain, thereby improving quality of life and allowing the patient to return to normal activity.

Painrelief effect

  • Pain reduction typically appears after several days (sometimes within 1–2 weeks).
  • The analgesic effect usually lasts from 6 months to 2 years.
  • In some patients, the pain does not return, or it remains much milder than before the procedure.
  • If pain recurs, the procedure can be repeated.
  • Thanks to the elimination of pain, patients can:
  • Reduce or discontinue pain medications.
  • Increase physical activity and range of motion.
  • Improve sleep quality and daytoday functioning.

Stages of the procedure

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STEP 1 – Positioning and disinfection

What the medical team does:

They position you comfortably on the procedure table, thoroughly disinfect the skin, and cover the area with sterile drapes.

What you feel:

A cool sensation from the disinfectant solution; no pain.

STEP 2 – Local anesthesia

What the doctor does:

Injects a small amount of local anesthetic into the area where the needle will be inserted.

What you feel:

A brief sting or burning sensation; after a moment the area becomes numb.

STEP 3 – Needle insertion under X-ray guidance

What the doctor does:

Using real-time X-ray guidance, the doctor slowly advances a thin needle with an electrode toward the targeted nerve.

What you feel:

A sensation of pressure or mild discomfort, but no significant pain, as the area is already numb.

Why is X-ray guidance so important?

Thanks to X-ray imaging, the doctor can clearly visualize the exact bony structures of the spine and accurately determine the course of the pain-conducting nerves. This allows for precise selection of the needle and electrode insertion point, which significantly increases the clinical effectiveness of the procedure.

STEP 4 – Stimulation test

What the doctor does:

Uses a brief electrical stimulation to confirm that the tip of the electrode is positioned precisely next to the nerve responsible for your pain.

What you feel:

A tingling sensation, a slight muscle twitch, or a quick “electric snap.” This is a normal part of the accuracy test

STEP 5 – Thermolesion (heating)

What the doctor does:

The doctor begins the actual treatment. The tip of the electrode heats up to approximately 80°C for about 60 seconds at a single point, which temporarily deactivates the nerve’s ability to transmit pain signals.

What you feel:

A sensation of warmth or gentle pressure, usually without pain.

STEP 6 – Dressing and rest

What the doctor does:

The doctor removes the electrode and needle, applies a small sterile dressing, and asks you to rest briefly in the recovery area.

What you feel:

Usually comfort; you can stand up and go home the same day.

Clinical notes

Thermolesion is a minimally invasive and safe procedure performed on an outpatient basis under local anesthesia.

Rest after the procedure

For the first 24 hours, avoid physical exertion. In the following 3–5 days, you should avoid:

  • lifting heavy objects,
  • bending,
  • intense physical activity and sudden movements.

Driving is safe once any temporary weakness or numbness has resolved—typically the next day.

Normal reactions after the procedure

You may experience:

  • mild pain at the injection site,
  • a sensation of pulling, burning, or numbness in the treated area,
  • temporary muscle weakness or stiffness.

These symptoms usually resolve within a few days to up to 2 weeks.

When to contact a doctor urgently

Seek medical attention immediately if you notice:

  • fever or chills,
  • worsening pain instead of gradual improvement,
  • discharge, redness, or swelling at the injection site,
  • micturition disorders or impaired defecation,
  • sudden weakness in the limbs.