Written by Dr. YT Chen
Propel Sports and Orthobiologics
How radiofrequency ablation works
Pain from a joint or tendon travels to the brain along small sensory nerves. Radiofrequency ablation places a thin needle-like probe next to one of these nerves and delivers radiofrequency energy through its tip. Conventional RFA uses gentle, controlled heat to interrupt the nerve's ability to send pain signals.
Pulsed radiofrequency is a lower-temperature variation that changes how a nerve signals without heating it enough to interrupt it. It is sometimes chosen for nerves that also carry muscle function or when a gentler approach fits better.
Why ultrasound guidance matters
Many RFA procedures have traditionally been done with X-ray guidance, which shows bone but not nerves or soft tissue. Ultrasound shows the small nerves, blood vessels, and tendons directly, so the probe can be placed precisely and important structures can be avoided.
Dr. Chen has published novel ultrasound-guided RFA techniques for resistant tennis elbow, golfer's elbow, and greater trochanteric pain syndrome, the outer hip pain linked to gluteal tendinopathy. These approaches target the sensory nerve branches supplying the painful area.
Conditions that may respond
RFA and joint denervation are most often used for arthritis of the knee, hip, and shoulder, and for other joints such as the sacroiliac joint. They can also help chronic tendon pain around the elbow and outer hip when months of strength training, activity changes, and injections have not provided lasting relief.
RFA is a pain treatment. It does not heal a tendon or change the structure of a joint, so it works best as part of a plan that keeps you exercising and building strength.
What to expect from the procedure
Most patients first have a diagnostic nerve block, a small injection of numbing medicine at the target nerves. If the pain eases clearly for several hours, RFA is more likely to help. The ablation itself is done in the office with local anesthetic, and it usually takes under an hour.
Soreness where the probe was placed is common and typically eases within the first week or two. Relief often builds over the following weeks. Because nerves slowly recover, pain can return over time, and the procedure can often be repeated if it helped.
Risks and who should not have RFA
Possible risks include temporary soreness, bruising, numbness or burning over the skin near the treated nerve, infection, and bleeding. Serious nerve injury is uncommon when the probe position is confirmed with imaging and testing.
RFA may not suit people with an active infection, uncontrolled bleeding problems, or pain whose source has not been clearly identified. Tell your physician if you have a pacemaker or other implanted device, since special precautions may be needed. When pain comes with new weakness, or a structural problem that needs surgery, we address that first and help coordinate referral.
Frequently asked questions
- Is radiofrequency ablation the same as a nerve block?
- No. A nerve block uses numbing medicine and wears off within hours. It is often done first as a test. Radiofrequency ablation uses controlled energy to quiet the nerve for a much longer period.
- Will radiofrequency ablation make the joint or tendon numb?
- RFA targets small sensory nerves that carry pain from deep in the joint or tendon, so the area should still move and work normally. Some people notice a small patch of altered skin sensation near the treated site. This usually fades over time.
- Can exercise continue after radiofrequency ablation?
- Yes. Most people return to light activity within a day or two and gradually resume their training. Continuing a strength program afterward is important, because RFA reduces pain but does not strengthen the joint or tendon.
- How long does pain relief from radiofrequency ablation last?
- Relief varies from person to person and depends on the joint or tendon treated. Because the treated nerves slowly recover, pain can gradually return. If the first treatment helped, it can often be repeated.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.