Anesthesiology | Interventional Pain Medicine
Assistant Professor — University of Toronto
Interventional Pain Physician — Afiya Spine & Pain Institute
Staff Anesthesiologist — Scarborough Health Network
Hip radiofrequency ablation is a procedure used to reduce pain signals carried by selected sensory nerve branches around the hip joint.
Radiofrequency ablation uses heat generated by specialized needles to disrupt the ability of these small nerve branches to carry pain signals from the hip region toward the brain.
The procedure does not replace the hip joint, remove arthritis, rebuild cartilage, or correct the underlying joint damage. It is designed to reduce pain so that walking, sleep, physiotherapy, strengthening, or daily function may be easier.
Most hip radiofrequency ablation procedures focus on articular branches from the femoral nerve and obturator nerve. These branches supply much of the front part of the hip capsule.
Some patients also have contribution from an accessory obturator nerve. The back part of the hip capsule can receive branches from other nerves, including the nerve to quadratus femoris, superior gluteal nerve, and sciatic nerve.
Because the most accessible and commonly targeted pain-carrying branches are usually from the femoral and obturator nerves, those are the main targets for this procedure.
In our clinic, we usually start with femoral articular branch targets first. Obturator articular branch targets may be added if prior blocks suggest they are needed or if pain remains refractory. The obturator target can be more uncomfortable, so we do not always include it as the first step.
This procedure is most commonly considered for chronic hip joint pain from osteoarthritis when pain remains significant despite medication, physiotherapy, exercise, walking aids, weight management, or injections.
Hip joint pain is often felt in the groin, front of the hip, thigh, buttock, or sometimes toward the knee. Pain may be worse with walking, standing, stairs, getting in and out of a car, putting on socks or shoes, or rotating the hip.
Hip radiofrequency ablation is usually considered after a positive hip articular branch block. A positive block suggests that the targeted articular branches are carrying a meaningful part of your hip pain.
Patients who may be good candidates include people who are not candidates for hip replacement surgery, people who do not want hip replacement surgery, and people using the procedure as a bridge while waiting for hip replacement.
For some patients who already have a hip replacement, hip radiofrequency ablation may be considered for persistent hip-region pain only after the surgeon has assessed the hip replacement and ruled out problems such as infection, loosening, fracture, instability, or other surgical complications.
Hip radiofrequency ablation is not a cure for arthritis. It is a palliative procedure, meaning it is intended to reduce pain signals rather than correct the underlying joint problem.
Tell us if you have a hip replacement booked within the next 6 months. Hip radiofrequency ablation itself does not inject steroid into the hip joint, but this information is important if any hip joint steroid injection is being considered at the same visit or nearby in time.
Tell us if you already have a hip replacement, have had recent hip surgery, have an active infection, are taking antibiotics, or have had a recent major change in your health.
You usually do not need to fast for this procedure unless you are specifically told otherwise.
The procedure is usually quick, but the full visit includes check-in, assessment, preparation, and recovery.
Most patients should expect the full appointment to take approximately 60 to 90 minutes, although this can vary depending on clinic flow that day.
The exact number and location of targets depends on your pain pattern, anatomy, imaging, and response to prior diagnostic blocks.
Most patients describe:
Local anesthetic is used to reduce discomfort. We usually start with femoral articular branch targets first partly because this is usually better tolerated.
You may walk and do normal light activity after the procedure. Avoid unusually strenuous activity for the rest of the day.
Do not drive until any numbness, weakness, heaviness, or altered sensation has fully resolved. If you feel lightheaded or weak after the procedure, do not drive.
Hip radiofrequency ablation is not judged only by the first few hours afterward. The effect can take time to develop.
Some patients notice improvement within 1 to 2 weeks. For others, improvement may take 4 to 6 weeks.
It is common to have temporary soreness or a pain flare before the benefit becomes clear.
The amount and duration of relief varies from person to person. Some patients have substantial relief, some have partial relief, and some do not improve.
When it works, relief may last several months. Evidence for hip radiofrequency ablation is still developing, and results are more variable than for some other radiofrequency procedures.
The next step depends on how much relief you have after the procedure and how long that relief lasts.
If your hip pain improves significantly, we may continue to monitor your response and focus on rehabilitation, walking tolerance, strengthening, weight management, or other conservative measures.
If your pain returns after a period of meaningful relief, repeat treatment may be considered depending on your response, goals, and overall treatment plan.
If your pain does not improve, or only partially improves, we would usually reassess. This may mean reviewing imaging, reconsidering the pain source, discussing hip joint injection options, considering whether obturator articular branch targets should be added, or recommending orthopedic review.
If you have not already had diagnostic testing, hip articular branch blocks are often used to help assess whether hip radiofrequency ablation is likely to help.
Keep the needle sites dry for 24 hours. Remove bandages after 24 hours.
If you develop a pain flare, this usually improves with time. Ice packs and over-the-counter pain relievers may help if you are allowed to use them. Avoid unusually strenuous activity for the rest of the day.
Hip radiofrequency ablation is a deeper procedure performed near important nerves and blood vessels.
The most common issues are temporary soreness, bruising, lightheadedness, temporary increase in pain, or temporary irritated-nerve discomfort.
Uncommon risks include bleeding, infection, allergic reaction, medication entering a blood vessel, temporary numbness or weakness, temporary hip or leg heaviness, skin burn, or worsening pain.
The femoral artery and vein are near the front of the hip region. X-ray guidance, careful positioning, and sterile technique are used to reduce risk.
Serious complications are very rare, but can occur with any procedure performed near nerves and blood vessels.
Tell us if you have a hip replacement booked within the next 6 months. We generally do not want to inject steroid into the hip joint if this could delay your surgery.
Seek medical attention if you develop fever, worsening redness or swelling at the needle site, drainage from the needle site, severe worsening pain, new leg weakness, or a hot swollen hip that does not settle.
The procedure itself, including the clinic visit and use of X-ray guidance, is covered by OHIP.
OHIP does not cover the cost of medications used or prescribed, such as local anesthetic, contrast dye, or other medications. These costs may be covered by private insurance.
The medication cost is usually in the range of $25 to $100, depending on the extensiveness of the procedure, but this may vary.
Unless you are told otherwise, you may usually take your regular medications. Blood thinners require separate review.
Tell us before the procedure if you take blood thinners or antiplatelet medications. Do not stop them on your own. We will give you specific instructions based on the medication and your medical history.
Tell us before the procedure if you have ever had an allergy or serious reaction to contrast dye, local anesthetic, or antiseptic skin-cleaning solution.
Tell us if you have diabetes, an active infection, are taking antibiotics, are pregnant or may be pregnant, have a hip replacement booked within the next 6 months, or have had a recent major change in your health.
Afiya Spine & Pain Institute
301 - 15 Wellesley St W, Toronto, ON M4Y 1G1
Phone: 416-413-7999 | E-Fax: 416-641-4520
For questions or concerns after your procedure, contact the clinic.