Specialties:
Sports Injuries, Badminton-Related Injuries, Concussion, Musculoskeletal Injuries, Frozen Shoulder, Shoulder Pain, Arthritis, Degenerative Joint Disease, Low Back Pain, Cervical Disc Herniation, Lumbar Disc Herniation, Exercise Prescription, Exercise Recommendations for Older Adults and Special Populations, Prolotherapy, Regenerative Medicine, Platelet-Rich Plasma (PRP) Injections, Ultrasound-Guided Injections, and X-ray–Guided Injections.

Radiofrequency Treatment — A New Option for Back Pain Relief

Lower back pain is extremely common, affecting up to 80% of people at some point in their lives. One of the common causes is a herniated lumbar disc, which may compress the spinal nerves. Besides back pain, patients often experience leg symptoms such as aching, tightness, numbness, tingling, or sharp pain, commonly known as sciatica. Herniated discs occur most frequently between the ages of 20 and 50, but may also happen in elderly, which are associated with prolonged sitting, poor posture, heavy lifting, and sports injuries.

Conventional treatments include rest, medication, physical therapy, and—when necessary—steroid nerve root injections. In the past, patients with persistent or worsening symptoms often needed surgery to decompress the nerve. However, it is important to note that imaging findings do not always match symptoms. Some people show significant disc herniation on MRI yet have no pain, while others experience severe pain without major imaging changes. This means an abnormal MRI does not automatically require surgery, and many patients improve through reinforced conservative care.

However, if red flags appear—such as loss of bladder or bowel control, sudden leg weakness, fever with possible severe infection, or neurological symptoms after a major injury—urgent surgical evaluation is required to avoid delayed treatment.
For patients without these emergency conditions, radiofrequency (RF) treatment has become a promising, minimally invasive alternative in recent years.

What Is Radiofrequency Therapy?

Radiofrequency (RF) therapy is a minimally invasive procedure that uses a special needle and electrical stimulation to reduce nerve hypersensitivity. Think of it this way: when a child falls and feels pain, an adult might gently blow on the injured area to soothe it. RF therapy works similarly—it “calms down” the irritated nerve so it stops sending excessive pain signals.

There are two main types:

1. Conventional Radiofrequency Ablation (RFA)

Uses high temperature to deactivate sensory nerves and provide pain relief.

2. Pulsed Radiofrequency (Pulsed RF)

Operates at a lower temperature (~42°C), does not burn or destroy the nerve, and mainly reduces pain by regulating nerve excitability and preventing the amplification of pain signals.

Studies show that for chronic nerve pain lasting more than three months, pulsed RF often provides longer-lasting relief compared to traditional injections alone.
RF can also be combined with regenerative treatments such as platelet-rich plasma (PRP) to support nerve healing, with some patients experiencing better outcomes than steroid injections.

How Is Radiofrequency Therapy Performed?

Your doctor will first conduct a detailed interview, physical examination, and imaging review (such as X-ray or MRI) to confirm that the pain is truly related to nerve compression.

Because the spine is surrounded by bone and ultrasound cannot penetrate bone structures, the procedure requires X-ray guidance and contrast dye to accurately reach the nerve. Therefore, RF treatment is performed in medical facilities equipped with appropriate imaging technology.

Procedure Overview

• Patients taking anticoagulants may need to discuss temporary discontinuation to reduce bleeding risk.
• Most patients lie face-down during the procedure.
• Depending on the number of nerves treated, the entire procedure takes 30–60 minutes.
• It is an outpatient procedure. Only a tiny puncture is required, hospitalization is not needed, and patients can go home after a brief observation period.

Most patients can walk normally afterward. A small number may experience temporary soreness or numbness, which usually improves within a few days.

Who Is a Good Candidate for Radiofrequency Treatment?

How Long Does the Relief Last?**

RF therapy may be suitable for patients with:

• Confirmed sciatica caused by nerve root compression
• Limited improvement from medication, physical therapy, or traditional injections
• A desire to reduce or delay the need for surgery
• Medical conditions that make surgery higher risk (elderly patients, multiple comorbidities, anesthesia concerns)

The duration of pain relief varies by individual and depends on factors such as degree of nerve compression, lifestyle habits, and muscle condition.

A helpful analogy:

Even if a professional cleaning service tidies up your home, it will become messy again quickly if things are thrown around the next day.
RF therapy can reduce your pain, but long-term improvement depends heavily on your own habits — posture correction, reducing long sitting time, and regular core muscle training.

Active rehabilitation is strongly recommended to maintain the benefits, rather than relying solely on passive treatments.

Summary

Although herniated discs and sciatica can be frustrating, not all patients require surgery. Only those with urgent warning signs or progressive neurological deficits should prioritize surgical treatment. For many patients with recurrent symptoms that have not yet reached the threshold for surgery, radiofrequency therapy is a safe, effective, and fast-recovery option, often considered the final step before surgical intervention.

If you are experiencing lower back pain or sciatica, we encourage you to consult with a medical professional to determine the most appropriate treatment—so you can restore your comfort and improve your quality of life as soon as possible.

Advanced biplane fluoroscopy (dual-plane X-ray) to perform highly precise image-guided injections

After guiding the needle to the correct location under X-ray, contrast is used for confirmation before performing the targeted treatment

The interdisciplinary pain management team at Far Eastern Memorial Hospital (second from the left, Dr. Wei-Ting Lin; center, Dr. Yu-Ping Huang; and radiologic technologists and nursing staff).