By the Pain Management Team at Performance Pain and Sports Medicine
Suzanne Manzi, MD · Matthias Wiederholz, MD · Jade Nemeth, PA-C
Updated April 2026
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Radiofrequency ablation (RFA) is a minimally invasive, image-guided procedure that uses controlled heat to disrupt the nerves responsible for transmitting chronic pain signals. For patients in Houston living with persistent back pain, neck pain, or joint pain that has not responded to conservative treatment, RFA may offer months of meaningful relief without surgery.
At Performance Pain and Sports Medicine, located in the T-Mobile Tower on the Southwest Freeway, the physicians at Performance Pain and Sports Medicine perform radiofrequency ablation under fluoroscopic guidance to treat facet joint pain, sacroiliac joint dysfunction, and other sources of chronic nerve-related pain. Each procedure begins with a thorough evaluation and diagnostic nerve block to confirm the source of your pain before treatment.
If you have been searching for a non-surgical option to manage chronic pain, RFA is one of the most well-studied interventional procedures available today.
What Is Radiofrequency Ablation?
Radiofrequency ablation is a non-surgical procedure that uses radiofrequency energy to generate a precise, controlled heat lesion on targeted nerve tissue. This heat disrupts the nerve’s ability to send pain signals to the brain, providing relief that can last for several months or longer.
The procedure is performed under fluoroscopic guidance, a form of real-time X-ray imaging that allows the treating physician to place the treatment needle with pinpoint accuracy. The American Society of Interventional Pain Physicians (ASIPP) considers fluoroscopic or CT guidance mandatory for all facet joint interventions, including RFA (Manchikanti et al., Pain Physician, 2020).
RFA does not permanently destroy nerves. The targeted nerve fibers can regenerate over time, which is why pain may gradually return after 6 to 12 months or longer. When that happens, the procedure can be repeated. A systematic review of randomized controlled trials found that RFA provides statistically significant pain reduction for patients with lumbar facet joint and sacroiliac joint pain (Leggett et al., Pain Research & Management, 2014).
RFA is not appropriate for every type of pain. It works best when the pain source has been confirmed through a diagnostic nerve block prior to the procedure.
Conditions Treated with RFA in Houston
The board-certified pain medicine specialists at Performance Pain and Sports Medicine evaluate each patient to determine whether radiofrequency ablation is the right approach for their specific condition. RFA is most effective when the pain originates from a nerve that can be precisely targeted under image guidance.
Conditions commonly treated with RFA at the Houston practice include:
- Lumbar facet joint pain, one of the most frequent causes of chronic low back pain. Facet joints can become inflamed through arthritis, injury, or age-related wear, producing persistent pain that limits daily activity.
- Cervical facet joint pain, a common source of chronic neck pain and cervicogenic headaches. A systematic review found Level II evidence supporting cervical facet RFA for chronic neck pain (Suer et al., Pain Physician, 2022).
- Sacroiliac joint pain, which often causes lower back and buttock pain that worsens with sitting or standing for extended periods.
- Genicular nerve pain from knee osteoarthritis, where RFA targets the nerves surrounding the knee joint to reduce chronic knee pain without surgery.
Each of these conditions requires a confirmed diagnosis through a diagnostic medial branch block or lateral branch block before RFA is recommended.
How Radiofrequency Ablation Works
The path from consultation to procedure follows a careful, step-by-step process designed to confirm your diagnosis before any treatment is performed.
Step 1: Consultation and Evaluation
Your first visit at our Houston office begins with a comprehensive pain evaluation. Your provider reviews your medical history, imaging studies, and prior treatments to understand your condition. Physical examination and diagnostic imaging help determine whether your pain pattern is consistent with facet joint, sacroiliac joint, or other nerve-mediated pain that may respond to RFA.
Step 2: Diagnostic Medial Branch Block
Before performing radiofrequency ablation, your physician uses a diagnostic medial branch block to confirm the exact source of your pain. During this procedure, a small amount of local anesthetic is injected near the medial branch nerves under fluoroscopic guidance. If you experience significant temporary pain relief, this confirms that those specific nerves are transmitting your pain signals. This step protects you from undergoing a procedure that may not address the true source of your discomfort.
Step 3: RFA Procedure Day
On procedure day, you arrive at our Houston office where your physician performs RFA using fluoroscopic guidance. After numbing the treatment area with a local anesthetic, a thin needle is inserted to the targeted nerve. A microelectrode delivers radiofrequency energy that heats the nerve tissue to a precise temperature, disrupting its ability to transmit pain signals.
The entire procedure takes 30 to 60 minutes. Most patients walk out shortly afterward and return home the same day. For a complete overview of the procedure and conditions treated, visit the back pain treatment page.
Benefits of Radiofrequency Ablation
Research supports RFA as one of the most effective non-surgical options for chronic facet joint and sacroiliac joint pain. A systematic review and meta-analysis found that all three RFA techniques provided significant pain improvement for up to 12 months, with no serious complications reported (Shih et al., Clinical Neurology and Neurosurgery, 2020).
Key benefits of RFA include:
- Long-lasting pain relief. Many patients experience 6 to 12 months of significant relief, with some reporting improvement beyond a year.
- Minimally invasive. RFA requires only a thin needle and local anesthetic. There are no incisions and no stitches.
- Same-day outpatient procedure. Most patients return home within an hour and resume normal activities within a few days.
- Reduced reliance on pain medication. By addressing the nerve signal directly, RFA may decrease the need for ongoing oral pain medications.
- Repeatable when needed. Because the targeted nerves can regenerate over time, the procedure can be safely repeated to maintain relief.
- Non-surgical alternative. For patients with chronic back pain treatment needs who want to avoid or delay surgery, RFA offers a proven interventional option.
Your results will depend on your specific diagnosis, the location of the treated nerves, and how your body responds to the procedure.
Risks and What to Expect After RFA
Radiofrequency ablation is considered a low-risk procedure, but as with any medical intervention, there are potential side effects discussed with every patient before proceeding.
Common side effects (typically resolve within 1 to 2 weeks):
- Mild soreness or discomfort at the treatment site
- Temporary numbness in the treated area
- Minor bruising or swelling
Rare side effects:
- Infection at the needle insertion site
- Prolonged numbness or nerve irritation
- Allergic reaction to the anesthetic
Serious complications from RFA are uncommon. A meta-analysis of RFA techniques for facet joint and sacroiliac joint pain reported no serious complications across the studies reviewed (Shih et al., Clinical Neurology and Neurosurgery, 2020).
Recovery timeline:
Most patients return to normal daily activities within a few days. You may experience mild soreness at the procedure site for one to two weeks. The full therapeutic effect of RFA typically develops over two to four weeks as the treated nerve tissue responds to the procedure. A follow-up appointment is scheduled to assess your results and adjust your care plan if needed.
What Our Houston Patients Are Saying
The experiences of patients who have undergone radiofrequency ablation at our Houston practice reflect the relief that is possible when chronic pain is accurately diagnosed and treated at its source.
“My experience at Performance Pain and Sports Medicine has been nothing less than excellent. From the check in desk, to Dr. Manzi, everyone is extremely friendly and helpful. Dr. Manzi takes the time to explain options to you, in terms that are understandable. I have had chronic back issues and have had an ablation, done in the office, and felt better almost immediately. I have knee issues also and have been treated for the pain. Her partner, Dr. Wiederholz, is also top notch. I highly recommend this practice!”
— Diane, Houston
Individual results may vary. This testimonial reflects a real patient experience but does not guarantee specific outcomes.
Why Choose Performance Pain for RFA in Houston
Choosing the right practice for radiofrequency ablation matters. RFA outcomes depend on accurate diagnosis, precise needle placement, and proper patient selection. These require physicians with advanced training in interventional pain management and image-guided procedures.
At Performance Pain and Sports Medicine, the Houston RFA team includes:
- Dr. Suzanne Manzi, MD — Board-certified in Pain Medicine and Physical Medicine & Rehabilitation, with residency training at Baylor College of Medicine and fellowship training in interventional spine and pain management. Dr. Manzi is quadruple board-certified in Physical Medicine & Rehabilitation, Pain Medicine, Electrodiagnostic Medicine, and Obesity Medicine. She currently serves as off-site clinical faculty at UT Health Houston McGovern Medical School and is a founding member of the Society of Women Innovators in Pain Management.
- Dr. Matthias Wiederholz, MD — Quadruple board-certified in Physical Medicine & Rehabilitation, Sports Medicine, Pain Medicine, and Regenerative Medicine. Dr. Wiederholz brings extensive experience in fluoroscopy-guided interventional procedures.
- Jade Nemeth, PA-C — Physician assistant specializing in interventional pain management, providing comprehensive support throughout your evaluation and treatment.
Together, the team provides personalized interventional pain management for each patient at the Houston office.
Performance Pain and Sports Medicine
Address: 4126 Southwest Freeway, Suite 1700, Houston, TX 77027
Landmark: T-Mobile Tower, 17th Floor
Major Cross Streets: I-59 (Southwest Freeway) at 610 (West Loop)
Parking: Covered garage with validation provided
Phone: 346-217-1111
Conveniently located near the Galleria and accessible from River Oaks, West University, Bellaire, and the Medical Center area, the Houston office provides a comfortable setting for both consultations and in-office procedures.
Frequently Asked Questions About RFA in Houston
How long does radiofrequency ablation last?
Most patients experience pain relief lasting 6 to 12 months. Some patients report relief beyond a year. Because the targeted nerves can regenerate over time, pain may gradually return. When it does, RFA can be repeated to restore relief. Clinical studies have shown significant pain reduction lasting up to 12 months across multiple RFA techniques (Shih et al., Clinical Neurology and Neurosurgery, 2020).
Is radiofrequency ablation painful?
Most patients tolerate the procedure well. The treating physician applies a local anesthetic to numb the treatment area before inserting the needle. You may feel a brief sensation of pressure or warmth during the radiofrequency portion. Mild sedation is available for patients who experience anxiety about the procedure.
How long is recovery after RFA?
Most patients return to daily activities within a few days. Mild soreness at the treatment site is common for one to two weeks. The full pain-relieving effect typically develops over two to four weeks.
Does insurance cover radiofrequency ablation?
Many insurance plans cover RFA when it is deemed medically necessary and a diagnostic medial branch block has confirmed the pain source. Coverage varies by plan. Call the Houston office at 346-217-1111 to discuss coverage before scheduling a consultation.
What is the difference between a nerve block and RFA?
A medial branch block is a diagnostic procedure that temporarily numbs the nerve with local anesthetic to confirm it is the source of your pain. Radiofrequency ablation is the therapeutic procedure that follows, using heat to disrupt the nerve for longer-lasting relief. The block typically lasts hours; RFA may provide relief for months.
Am I a candidate for RFA?
Candidates for radiofrequency ablation typically have chronic facet joint pain, sacroiliac joint pain, or other nerve-mediated pain that has not responded to conservative treatments such as physical therapy or medication. A successful diagnostic medial branch block is required before RFA is performed. The physicians at Performance Pain and Sports Medicine evaluate each patient individually during a consultation at the Houston practice to determine whether RFA is appropriate.
Schedule Your Houston RFA Consultation
If chronic back pain, neck pain, or joint pain has not responded to conservative treatment, radiofrequency ablation may help you find lasting relief. Patients are welcome to schedule a consultation at the Houston office to discuss whether RFA is right for your condition.
Performance Pain and Sports Medicine
4126 Southwest Freeway, Suite 1700, Houston, TX 77027
Phone: 346-217-1111
MEDICAL DISCLAIMER
This article is for educational purposes only and does not replace professional medical advice, diagnosis, or treatment. The information presented reflects an interventional pain management perspective and is intended to support, not substitute, your relationship with a qualified healthcare provider. Individual results vary based on diagnosis, pain duration, overall health, and response to treatment. Some procedures may not be covered by insurance. Treatment outcomes depend on proper patient selection and accurate diagnosis. Always consult a board-certified physician before pursuing any pain management treatment.
Performance Pain and Sports Medicine
Medically reviewed by Suzanne Manzi, MD
Board-Certified in Physical Medicine & Rehabilitation, Pain Medicine, Electrodiagnostic Medicine, and Obesity Medicine
Last reviewed: April 2026
