TheHEALTH May/June 2025 | Page 30

30 COLUMN The HEALTH | May-June. 2025

A precision approach

• Radiofrequency ablation( RFA) uses heat to disrupt pain-signalling nerves, providing relief that can last from six months to two years without the need for surgery.
• It is particularly effective for knee, shoulder, and spine pain due to arthritis or degeneration- especially when traditional treatments fail or surgery isn ' t an option.
• The outpatient procedure typically takes under an hour, with most patients resuming normal activities within days and experiencing significant pain reduction and improved function.
BONE TO PICK
Dr Jonas Fernandez is an Orthopaedic Surgeon at Putrajaya Hospital. He is also a member of the Malaysian Arthroscopy Society( MAS).

THERE ' S a phrase in the English language that is rather peculiar, " there is more than one way to skin a cat ". Where this phrase originated often baffled me, but that ' s a mystery for another day.

The phrase means that there are many methods one could employ to achieve a goal. The same could be said in medicine, and orthopaedics is no different. In this article, we examine the application of radiofrequency ablation( RFA) in the management of joint pain.
The goal of any treatment for patients with joint pain is to minimise the pain as much as possible and help them regain mobility. Let ' s use knee osteoarthritis as an example. Patients with advanced stages of arthritis often suffer from debilitating pain, and frequently, they require surgery to replace the damaged joints.
Unfortunately, sometimes, these patients are in the latter stages of life and may not be suitable candidates for surgery. This is where RFA comes in handy. An alternative way is to " skin the cat ".
Chronic pain in the knees, shoulders, and spine can significantly impact quality of life, limiting mobility and daily activities. While medications, physical therapy, and surgery are common treatments, radiofrequency ablation has emerged as an effective, minimally invasive option for long-term pain relief.
This procedure is particularly beneficial for patients with degenerative joint disease and other chronic pain conditions who have not responded to conservative treatments.
HOW RADIOFREQUENCY ABLATION WORKS
Radiofrequency ablation is a procedure
that uses heat generated by radio waves to disrupt pain signals from specific nerves. By targeting sensory nerves responsible for transmitting pain, RFA provides lasting relief without the need for major surgery. The effects can last from several months to over a year, and the procedure can be repeated if necessary.
RADIOFREQUENCY ABLATION FOR KNEE PAIN
Knee osteoarthritis is one of the most common conditions treated with RFA. As the cartilage wears down, the bones rub against each other, causing inflammation and pain. The knee joint is innervated by sensory nerves that transmit pain signals to the central nervous system, specifically the brain. RFA targets these nerves, offering significant relief.
How is the procedure performed for the knee:
• Patient Preparation – The patient lies on an exam table, and the skin around the knee is cleaned and numbed with local anaesthesia.
• Guided Needle Placement – Using fluoroscopy( real-time X-ray) or ultrasound guidance, the physician inserts a thin needle near the affected nerves. Common targets include the genicular nerves, which are responsible for knee pain sensation.
• Sensory and Motor Testing – Before applying heat, a small electrical current is passed through the needle to confirm proper placement. The patient may feel a mild tingling sensation, but this ensures the needle is not near motor nerves( which control movement).
• Radiofrequency Lesioning – Once the correct position is confirmed, a radiofrequency current heats the nerve tissue( typically to around 60-80 ° C), creating a lesion that disrupts
pain signals.
• Recovery – The procedure takes about 30-60 minutes, and patients can usually go home the same day. Some may experience mild soreness, but most resume normal activities within a few days.
RFA FOR SHOULDER AND SPINE PAIN
While knee pain is a primary application, RFA is also used for:
• Shoulder Pain – Targets nerves such as the suprascapular nerve to relieve chronic shoulder pain from arthritis or rotator cuff injuries.
• Spine Pain – Used for facet joint arthritis or sacroiliac joint pain, where medial branch nerves are ablated to reduce back pain.
Benefits of Radiofrequency Ablation:
• Long-lasting relief – Pain reduction can last " six months to two years ".
• Reduces reliance on pain medications – Offers an alternative to opioids or NSAIDs.
• Improved mobility – Patients often experience better joint function.
To summarise, radiofrequency ablation is a safe, effective treatment for chronic joint pain, particularly in the knee. By selectively targeting pain-transmitting nerves, RFA provides significant relief without surgery.
TIf you suffer from persistent knee, shoulder, or spine pain that hasn ' t improved with other treatments, consult your friendly neighbourhood orthopaedic specialist to see if RFA is right for you.- The HEALTH