Treatments

Turning down the signal.

When a structure cannot be repaired, the nerves carrying its pain signal can often be interrupted. That is the principle behind both radiofrequency ablation and neurostimulation.

Request an appointment Insurance & cost

Two different tools

Radiofrequency ablation uses heat delivered through a needle to interrupt the small sensory nerves carrying pain from a specific joint. It is used most often for facet joints in the neck and lower back, and for the genicular nerves of an arthritic knee. It is not done speculatively: a diagnostic block has to confirm those nerves are carrying your pain first. Relief commonly lasts many months, and the procedure can be repeated when the nerves regenerate.

Neurostimulation places a small lead near the spinal cord or a peripheral nerve and delivers mild electrical stimulation that changes how pain signals are perceived. It is for pain that has not responded to other treatment — persistent nerve pain in the legs, pain after spine surgery, painful diabetic neuropathy, complex regional pain syndrome. Crucially, it starts with a trial: a temporary lead is placed for several days so you find out whether it helps you before anything permanent is implanted.

What each is used for

Lumbar radiofrequency ablation

For lower back pain confirmed as facet-mediated by medial branch blocks.

Cervical radiofrequency ablation

For neck pain and cervicogenic headache arising from the cervical facet joints.

Genicular nerve ablation

For knee osteoarthritis pain, including in advanced arthritis where the joint itself cannot be changed.

Spinal cord stimulation

For persistent leg or back pain after spine surgery, painful diabetic neuropathy and complex regional pain syndrome.

Peripheral nerve stimulation

A lead placed alongside a specific peripheral nerve for focal neuropathic pain.

Common questions

How long does radiofrequency ablation last?

Commonly six to twelve months, sometimes longer. The treated nerves regenerate over time, and the procedure can be repeated when symptoms return.

Why do I need two blocks before ablation?

Because the ablation is only worth doing if those nerves are genuinely carrying your pain. Confirming that with blocks before committing to a longer-lasting procedure is what separates a targeted treatment from a guess — and most insurers require it too.

Does ablation cause weakness?

The medial branch nerves treated are sensory nerves supplying the joint, not the nerves that power your legs or arms. Dr. Loch will go through the specific risks with you before you consent.

What does a stimulator trial involve?

A temporary lead is placed through a needle and connected to an external device you wear for several days at home. You go about normal life and see how much your pain changes. Only if the trial gives you meaningful relief is a permanent system considered.

Can I have an MRI with a stimulator?

Most current systems are MRI-conditional, meaning scans can be performed under specified conditions. We will go through what your particular device allows.

Eliminate pain and reclaim your life.

Request an appointment with Dr. Loch, or call the office at (904) 750-3787. Most patients are seen within a week.

Request an appointment