Radiofrequency Ablation (RFA) for Chronic Nerve Pain in Chicago
Radiofrequency ablation (RFA) uses controlled heat from a thin needle to switch off the small sensory nerve that is carrying a pain signal. It is done only after a test injection, called a diagnostic nerve block, confirms that the targeted nerve is the source of the pain. Dr. Nidal Elbaridi performs RFA at our South Loop and Streeterville offices.
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Workers’ Comp, HMO referral or complex insurance? Call (312) 414-1088.
Other names for nerve RFA
Radiofrequency ablation, RFA, radiofrequency neurotomy, radiofrequency denervation, or nerve ablation. These are all names for the same nerve treatment.
Nerve RFA is different from the radiofrequency ablation (ClosureFast) we use to close a faulty vein in the leg. Both use radiofrequency energy, but they treat different problems.
How we confirm the right nerve first: diagnostic nerve blocks
- Before RFA, the target nerve is tested with a nerve block. This is an injection of local anesthetic without steroid, so the result is a clean test.
- If the block gives immediate pain relief, that confirms the nerve is the pain generator.
- Many patients receive two blocks on separate days. The first uses a shorter-acting local anesthetic and the second a longer-acting one. Relief that matches each anesthetic’s duration confirms the diagnosis before ablation.
- Blocks can be done on a single sensory nerve or on a ganglion (a nerve cluster).
Only sensory nerves are treated
RFA is performed only on sensory nerves, the nerves that carry pain. It is not performed on motor nerves, the nerves that move your muscles.
Nerves we commonly treat with RFA
| Nerve | Area / typical pain |
|---|---|
| Medial branch nerves (cervical, thoracic, lumbar) | Facet joint pain in the neck, mid back, low back |
| Suprascapular nerve | Shoulder |
| Intercostal nerves | Chest wall / rib |
| Cluneal nerves | Buttock / upper buttock |
| Iliohypogastric and ilioinguinal nerves | Lower abdomen / groin |
| Obturator nerve (sensory branches) | Hip / groin |
| Basivertebral nerve (basivertebral nerve ablation) | Inside the vertebral body: vertebrogenic low back pain. Reached through a vertebroplasty-style approach. |
Ganglion blocks and ablation (sympathetic / parasympathetic)
- Trigeminal ganglion: face
- Stellate ganglion: neck, arm, upper chest
- Celiac plexus: upper abdomen
- Hypogastric plexus: pelvis
- Lumbar sympathetic: leg
- Ganglion impar: tailbone and perineum
Cancer pain: neurolysis
For cancer pain, sympathetic nerves can also be treated with neurolysis, which is a longer-lasting nerve interruption. It can be done with radiofrequency, phenol, or 100% alcohol.
Talk to Dr. Elbaridi about RFA
Same-week appointments at our South Loop and Streeterville offices.
Opens our secure booking calendar — this page stays open.
Workers’ Comp, HMO referral or complex insurance? Call (312) 414-1088.
Your comfort during the procedure (what sets us apart)
Comfort
- Every procedure starts with topical and local anesthetic to numb the skin and the deeper tissue.
- An IV is always offered, and light sedation is available, with full monitoring throughout.
- Many practices use general anesthesia or monitored anesthesia care (MAC) for RFA and other pain procedures. We can provide that too. With an experienced team, most patients don’t need it.
- If you choose sedation, please bring a companion (chaperone) with you for safety.
How long it takes
- The procedure itself usually takes 5–10 minutes in the procedure room. That is true of most of our pain procedures.
- Local anesthetic only: plan on 30–60 minutes at the office in total. That covers check-in, changing, consent, the procedure, recovery and your after-care instructions.
- With sedation: plan on a longer visit. We take extra time to keep you comfortable and to move you safely out of the procedure room, and we follow strict discharge guidelines before you go home with your companion.
Image-guided needle placement
- Spine nerves (medial branch, basivertebral): guided by fluoroscopy, a live X-ray.
- Peripheral nerves (suprascapular, intercostal, cluneal, ilioinguinal, iliohypogastric, obturator): guided by ultrasound.
Relief, recovery and what comes next
How long relief lasts
When RFA is done properly, relief typically lasts 3–6 months, which is about how long it takes the nerve to regenerate.
No steroids
RFA uses no steroids. That makes it a strong option for patients who should limit steroid exposure, such as people with diabetes or obesity, and patients who would otherwise need repeated steroid injections.
RFA is a bridge to recovery, not a lifelong treatment
We believe movement is the essence of recovery: physical therapy, yoga and strengthening. Pain management is an important intermediate step. It brings pain down enough for you to do the work that keeps you better.
- We do not market RFA as a procedure to repeat indefinitely. If it is needed again, it can be repeated, typically 1–2 years after a successful first procedure that gave significant relief.
- RFA is a far better treatment strategy than long-term opioid pain medication.
Recovery
Light activity is fine the same day, and most patients return to work the next day. Relief builds over the following few weeks.
Dr. Nidal Elbaridi, MD
- Anesthesiologist and interventional pain physician
- Interventional pain fellowship, Harvard Medical School / Brigham and Women’s Hospital (2016)
- Anesthesiology residency, John H. Stroger Jr. Hospital of Cook County (2015)
- MD, Ross University School of Medicine (2010)
- Former licensed physical therapist (B.S., Indiana University, 1997)
Insurance and prior authorization
- We pre-authorize every procedure, RFA included, before it is scheduled.
- If successful nerve blocks show you are a candidate, RFA is offered and we obtain prior authorization from your insurer.
- We do not charge out-of-network rates. We verify benefits and pre-authorize before your procedure, so there are no surprise bills afterward.
Most insurance accepted, including Medicare, Medicare Advantage, PPO and HMO plans. Coverage depends on medical necessity — we verify before your visit.
Who is not a candidate
RFA is not done when:
- the diagnostic nerve blocks did not relieve your pain
- there is an active infection, at the site or in the body
- you have a pacemaker or defibrillator and it has not been cleared or managed first
- your bleeding risk is uncontrolled (a bleeding disorder, or blood thinners that can’t be safely held)
- you decline the procedure. It is always your choice.
RFA questions, answered
Does RFA hurt?
We numb the skin with topical and local anesthetic before anything else. An IV is always offered, and light sedation is available with full monitoring. Most patients describe pressure rather than pain, and the procedure itself takes 5–10 minutes.
Can I get sedation?
Yes. Sedation is available with full monitoring. If you choose it, please bring a companion with you, and plan a longer visit so we can follow safe discharge guidelines.
Is RFA the same as a steroid shot?
No. RFA uses no steroids. A diagnostic nerve block first confirms which nerve carries the pain, and RFA then uses heat to quiet that nerve. Because there is no steroid, it suits patients with diabetes or obesity and anyone who needs to limit steroid exposure.
Is RFA covered by insurance?
When successful nerve blocks show you are a candidate, we obtain prior authorization from your insurer before scheduling. We pre-authorize every procedure and do not charge out-of-network rates, so there are no surprise bills afterward.
Will I need it again?
Relief typically lasts 3–6 months, about the time a nerve takes to regenerate. We use that window to get you moving, with physical therapy, strengthening and yoga, so the result lasts. If needed, RFA can be repeated, typically 1–2 years after a successful first procedure.
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