Radiofrequency Therapy for Disc Herniation in Sharjah
Medically reviewed by Dar Al Kamal Team
What is radiofrequency therapy for disc herniation?
Radiofrequency therapy uses alternating electrical current at radio frequencies, delivered through a needle whose shaft is insulated and whose tip is bare. The energy acts only in a small zone around that tip, which is why exact positioning is the heart of the treatment. For a herniated disc, it is used in two quite different ways.
The first works on the disc. A probe placed in the centre of the disc uses radiofrequency energy to break down and remove a small channel of the inner jelly, lowering the pressure inside the disc so a contained bulge can ease back from the nerve. This is often called radiofrequency disc decompression or nucleoplasty.
The second works on the nerve. In pulsed radiofrequency, the needle tip is placed beside the dorsal root ganglion, the small swelling on each nerve root where pain signals from the leg are processed. The energy is delivered in brief pulses separated by rest periods, keeping the tissue below the temperature that would damage the nerve. The aim is to change how that ganglion transmits pain, while leaving feeling and strength intact.
At Dar Al Kamal Hospital, Sharjah, radiofrequency therapy is one of the needle-based options in the spinal pain service of the Neurosurgery department. It sits alongside epidural and foraminal injections and laser disc decompression.
Who needs it
Radiofrequency disc decompression suits adults with a contained bulge that matches their leg or arm pain on the MRI, where the disc still has good height. Pulsed radiofrequency to the nerve root suits people with persistent root pain, such as long-standing sciatica, often after an epidural or nerve root injection has helped only for a short time, or when steroid is best kept to a minimum, for example in people whose diabetes is hard to control.
Both are considered after the stepwise care set out on herniated disc treatment. The neurosurgeon decides which form fits your problem from the examination, the scan and your response to any earlier injection. Where the pain comes mainly from the back itself, the plan on back pain treatment is usually the starting point.
What happens
Radiofrequency therapy is done as a day case under local anaesthetic, with light sedation for some people. You lie face down, the skin is cleaned and numbed, and the neurosurgeon guides the needle into position using X-ray images.
Before any treatment energy is delivered, the position is tested with a tiny electrical signal. In a sensory test, you are asked whether you feel tingling or a buzzing sensation, and where; feeling it along the path of your usual pain confirms that the tip is at the right root. In a motor test, a stronger signal checks the distance from the nerves that move the leg, and a small twitch helps the doctor judge a safe position. Your answers during these tests are an active part of the procedure.
The treatment itself follows. For pulsed radiofrequency, many people feel little more than warmth or a mild pulsing. For disc decompression, a deep ache or pressure in the back is common as the probe works inside the disc. Local anaesthetic is often added around the root at the end, and a small plaster is applied.
Preparing for it
Tell the team if you have a pacemaker, an implanted defibrillator, a spinal cord stimulator or any other implanted electrical device, because the radiofrequency current can interfere with it and a plan is needed in advance. Also mention any metal implants near the treatment area, blood thinners, diabetes treatment and allergies.
Bring your MRI and the record of any earlier spinal injections, with how much and how long they helped. If light sedation is planned, you are given fasting instructions. Arrange a lift home.
Afterwards
A sore back or a sunburn-like tenderness near the needle site is common for a few days. After pulsed radiofrequency, any change in root pain tends to appear gradually over the following weeks, so a pain diary kept through that period is useful at follow-up.
Stay active with regular short walks and return to normal tasks step by step. Office workers can usually start with shorter days; drivers and people in manual jobs should build up more gradually. In the UAE summer, drink plenty of water and walk in cooler hours.
Contact the hospital if you develop a fever, redness or swelling at the needle site, or a burning pain in the leg that grows steadily worse. **Go to the emergency department straight away for new weakness in a leg, numbness around the groin or buttocks, or any change in bladder or bowel control.**
Cost and insurance
UAE insurers assess radiofrequency disc and nerve procedures case by case, and pre-approval is required. Approval is more likely with an MRI that matches your symptoms and notes showing earlier injections and conservative care. Some plans exclude disc decompression procedures while covering pulsed treatment to the nerve, or the reverse. Dar Al Kamal Hospital, Sharjah can help you check your cover on 06 599 7777.
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Frequently asked questions
What are the risks of radiofrequency therapy for a herniated disc?
Radiofrequency therapy for a herniated disc carries small risks of infection, bleeding, a temporary increase in pain, and nerve irritation or numbness near the treated root. Disc decompression also carries a small risk of infection inside the disc. The neurosurgeon explains how these risks apply to you before you decide.
Is pulsed radiofrequency the same as nerve ablation?
Pulsed radiofrequency is different from nerve ablation. Ablation heats a small nerve until it stops carrying signals and is used for pain from the small facet joints of the spine, while pulsed radiofrequency keeps the tissue below that temperature and aims to calm the pain signals of a root that also controls feeling and strength in the leg.
Does radiofrequency therapy work for sciatica?
The evidence for radiofrequency therapy in sciatica from a herniated disc is still developing, and results vary from person to person. Your neurosurgeon will explain the realistic outcome for your case and how it compares with injections or surgery.
Why do I need to answer questions during radiofrequency treatment?
During radiofrequency treatment, your answers to the sensory and motor tests confirm that the needle tip is next to the right nerve and at a safe distance from the nerves that move the leg. That feedback is the reason the procedure is usually done with you awake.
Can I have radiofrequency therapy if I have a pacemaker?
Radiofrequency therapy in a person with a pacemaker or implanted defibrillator needs advance planning with the cardiology team, because the current can interfere with the device. Tell the team about any implant at your first appointment.
Can radiofrequency treatment be repeated?
Pulsed radiofrequency can be repeated if it helped and the pain later returns. The neurosurgeon reviews your pain diary and examination before offering a further treatment or a different option.
Will radiofrequency therapy leave my leg numb?
Pulsed radiofrequency is designed to leave feeling and strength in the leg unchanged, although a patch of tingling or altered sensation can occur for a while. Numbness from the local anaesthetic usually wears off the same day.
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