🎯 Nerve Ablation (Radiofrequency) Chronic Pain Simulator

Chronic Joint Pain & Sensory Signaling

Damaged joints send constant pain signals through specific sensory nerve branches.

• ~51 M: US adults with chronic pain (CDC estimate)
• ~14 M: Knee OA pain prevalence (US adults affected)
• Millions/yr: Opioid prescriptions for joint pain (driving the search for alternatives)
• 3 main: Genicular nerve branches (knee) (superior/inferior medial, superior lateral)

How joints generate pain signals

Inflamed joint tissue fires nociceptors that reach the brain via named nerve branches.

Why opioids fall short here

Opioids dull perception everywhere but don't fix the local signaling pathway.

Targeting the messenger, not the brain

RFA interrupts the specific nerve carrying pain, sparing motor and other function.

Diagnostic Nerve Block

A local anesthetic injection confirms the identified nerve truly carries the pain.

• Lidocaine/bupivacaine: Anesthetic used (short-acting local)
• ≥50%: Pain relief threshold (needed to proceed to RFA)
• Hours: Block duration (temporary, diagnostic only)
• 1–2: Typical confirmatory blocks (done before ablation)

Why a test block comes first

It proves the chosen nerve, not another source, is driving the pain.

Reading the response

Significant temporary pain relief predicts a good ablation outcome.

Guarding against false positives

Some clinics repeat the block to rule out placebo response.

RF Probe Placement

A thin insulated needle is guided next to the confirmed nerve.

• Fluoroscopy/ultrasound: Guidance method (real-time imaging)
• ~5–10 mm: Needle exposed tip (active heating surface)
• <5 mm: Placement accuracy target (from nerve course)
• Outpatient: Procedure setting (local anesthesia only)

Positioning the active tip

The exposed electrode is placed parallel to the nerve's path.

Confirming placement

Sensory and motor stimulation tests verify correct probe position.

Minimizing collateral tissue effects

Careful placement avoids nearby motor nerves and vessels.

Thermal Radiofrequency Ablation

Alternating current at the tip heats tissue enough to disrupt nerve fibers.

• 60–90°C: Typical temperature (at electrode tip)
• 60–90 sec: Lesion duration (per ablation cycle)
• Coagulative necrosis: Mechanism (of nerve fiber tissue)
• Larger lesion: Cooled-RF option (via internally cooled probes)

How RF energy makes heat

Ionic agitation from alternating current heats tissue around the tip.

Disrupting nerve conduction

Heat denatures axonal structures, halting electrical signal transmission.

Dose matters

Higher temperature and longer duration create a larger, longer-lasting lesion.

Sustained, Non-Opioid Pain Relief

The ablated nerve stays silent for months while it slowly regenerates.

• 6–12 mo: Typical relief duration (before regrowth)
• ~50–70%: Reported pain reduction (in responders)
• Often reduced: Opioid use after RFA (per clinical studies)
• Possible: Repeat treatment (once nerve regenerates)

Why relief isn't permanent

Peripheral nerves slowly regrow, eventually restoring signal transmission.

A repeatable, drug-free option

Ablation can be redone safely once symptoms return.

Fitting into pain management

RFA reduces reliance on systemic opioids for joint pain control.