About Ultrasound-Guided Nerve Ablation
Every joint and many tendons have small sensory nerves that send pain signals to the brain. Radiofrequency ablation places a thin needle-like probe next to one of these nerves and uses radio waves to heat it. The heat interrupts the nerve's ability to carry pain signals, while the muscles and the joint itself are left alone.
Dr. Chen performs RFA with ultrasound, which lets him see the nerve, nearby blood vessels, and the tip of the probe in real time. He has published ultrasound-guided RFA techniques for stubborn tennis elbow, golfer's elbow, and greater trochanteric pain syndrome on the outside of the hip. Pulsed radiofrequency, a lower-temperature version, is sometimes used when a nerve should be calmed rather than heated.
RFA does not change arthritis or heal a tendon. Its purpose is to lower pain enough that you can move, sleep, and train more comfortably. For most people it works best as part of a plan that includes progressive strength work.
Watch: Nerve Ablation explained
What happens during treatment
- 1.
A diagnostic nerve block comes first: Dr. Chen numbs the target nerves with a small amount of local anesthetic and you track how much your usual pain improves over the next several hours.
- 2.
If the block clearly helps, the RFA visit is scheduled. The skin is cleaned and numbed, and the probe is guided to each nerve under ultrasound.
- 3.
Before any heat is applied, a gentle test stimulation confirms the probe is next to a sensory nerve and away from nerves that control muscles.
- 4.
Each nerve is treated for a short period with the area fully numbed. Most visits take under an hour, and you go home the same day.
Who may be a good candidate
- People with chronic knee, hip, shoulder, or elbow pain that has not improved enough with exercise, activity changes, and injections.
- Adults with arthritis pain who want to delay joint replacement or who are not good surgical candidates.
- Athletes and active adults with long-standing tennis elbow, golfer's elbow, or outer hip pain that has resisted rehab.
- Anyone who had strong but short-lived relief from a diagnostic nerve block.
Recovery
Most people walk out of the office and return to light daily activity the next day. The treated area is often sore for several days, and some people notice a sunburn-like sensitivity of the skin for a week or two. Relief usually builds over two to four weeks as the nerves settle. We use that window to progress your strength program so the benefit carries over into better function.
Risks and limits
Common side effects include soreness, bruising, and temporary numbness or tingling over the treated area. Less often, the treated nerve becomes irritated and causes a burning pain that can last a few weeks. Infection, bleeding, and skin burns are rare. Nerves slowly grow back, so pain may return after months and the procedure may need to be repeated. RFA may not be right if you have an active infection, a bleeding disorder, or certain implanted devices such as a pacemaker without coordination with your cardiologist.
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.
Questions about Nerve Ablation
- Does radiofrequency ablation hurt?
- The skin and deeper tissues are numbed before the probe is placed, so most people feel pressure more than pain. Some areas can feel achy during treatment. Soreness for a few days afterward is common and usually eases with ice and over-the-counter medication.
- How long does relief from RFA last?
- Relief often lasts many months and sometimes longer, but it varies from person to person. Because the nerves slowly regrow, pain can return over time. If the first treatment helped, it can usually be repeated.
- Will RFA weaken my muscles?
- RFA targets small sensory nerves that carry pain, not the nerves that control muscles. A test stimulation is done before treatment to confirm the probe is in a safe position. Your strength should be unchanged, and many people find it easier to exercise once pain is lower.