Medically reviewed by Dr. David L. Greenwald, MD, FAANS, FACS — dual board-certified spine surgeon & neurosurgeon. Last reviewed October 2026.

For chronic pain that keeps returning after injections, ablation and stimulation provide durable relief. Radiofrequency ablation quiets the specific nerves carrying facet-joint pain for many months, while spinal cord stimulation masks severe nerve pain that hasn't responded to other care.

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What Are Radiofrequency Ablation & Spinal Cord Stimulation?

Radiofrequency ablation and spinal cord stimulation are two of the most powerful tools in interventional pain medicine for chronic back, neck, and nerve pain that keeps coming back. They share a single goal — interrupt the pain signal itself instead of simply masking it with medication — but they do it in very different ways, and each is matched to a specific kind of pain.

Radiofrequency ablation (RFA) uses precisely controlled heat, delivered through a thin needle under live imaging, to quiet the small medial-branch nerves that carry pain from an arthritic or injured facet joint. Because those nerves stop relaying the pain signal, relief from RFA typically lasts far longer than an injection — many months at a time — and the procedure can be repeated when the nerves gradually regenerate.

Spinal cord stimulation (SCS) takes a different approach for severe, chronic nerve pain that hasn't responded to other care. A small implanted device delivers gentle electrical pulses that mask the pain signal before it reaches the brain. Crucially, it is never placed "on faith" — you wear a temporary trial device first, so you know the relief is real before anything permanent is implanted. Both procedures are performed in Phoenix by Dr. David L. Greenwald, a dual board-certified spine surgeon and neurosurgeon — exactly the expertise you want for treatments that work directly with the nerves and spinal cord.

Our Ablation & Stimulation Procedures

Most people searching for help with long-lasting pain relief don't yet know which of these procedures is right for them — that's what the consultation is for. These are the two approaches we offer, each matched to a specific pain source:

When Are Ablation & Stimulation the Right Choice?

These procedures are not where we start — they're where we turn once simpler steps have told us exactly what we're dealing with. You may be a candidate when:

• Injections helped, but not for long. If an image-guided injection or diagnostic block eased your pain — even briefly — that temporary relief tells us the right target, and RFA can make that relief last far longer.
• Your pain comes from the facet joints. Aching, stiffness, and pain that worsens with bending or twisting often trace back to arthritic facet joints, the classic target for radiofrequency ablation.
• Severe nerve pain persists despite everything. When chronic leg, arm, or back pain hasn't responded to conservative care, injections, or even prior surgery, spinal cord stimulation can offer relief where other options have fallen short.
• You want to avoid or delay bigger surgery. For the right patient, these procedures control pain and restore function without an open operation — and without long-term reliance on pain medication.

The Right Step After Injections and Blocks

Ablation and stimulation aren't first steps — they're what we turn to once image-guided injections and nerve blocks have confirmed exactly where your pain comes from. That sequence is why our results last: we treat the proven source, not a guess. For spinal cord stimulation, we always do a temporary trial first, so you experience the relief before committing to a permanent device.

Precision That Makes Relief Last

What separates a lasting result from a disappointing one is accuracy — hitting the exact structure responsible for your pain. Both of these procedures are performed under live image guidance (fluoroscopy), so every needle and lead is placed precisely where it needs to be, confirmed in real time rather than estimated.

For radiofrequency ablation, that precision is what allows the heat to reach the specific medial-branch nerves feeding an arthritic facet joint while sparing everything around them. It's also the reason RFA delivers longer-lasting relief than a one-time injection: an injection calms inflammation for a while, whereas ablation quiets the pain-carrying nerve itself — so the comfort it brings is measured in many months, not days or weeks.

For spinal cord stimulation, precision drives the entire design of the treatment. Rather than ask you to commit to an implant and hope it works, we follow a trial-then-implant pathway: a temporary lead is positioned under imaging so you can live with the device for a short period and judge the relief for yourself. Only if that trial clearly improves your pain do we move forward with a permanent system — so the decision is based on your real experience, not a prediction.

What to Expect — From Consultation to Procedure

Both procedures are designed to be low-disruption, and we walk you through every step so there are no surprises:

• Consultation & diagnosis. Dr. Greenwald reviews your history, examines you, and studies your imaging to confirm the pain source — often building on how you responded to earlier injections or blocks.
• Radiofrequency ablation. RFA is a needle-based outpatient procedure. Using fluoroscopic guidance and local anesthetic, a slim probe delivers controlled heat to the target nerves. The procedure itself usually takes under an hour, and you go home the same day.
• Spinal cord stimulation — the trial. A temporary lead is placed through the skin so you can test the therapy during everyday activities. There's nothing permanent about this stage; the lead is simply removed afterward.
• Spinal cord stimulation — the implant. If the trial delivers meaningful relief, the permanent device is placed during a minor outpatient procedure. It can later be adjusted — and removed if ever needed.

Recovery & Getting Back to Life

Because these are minimally invasive, outpatient procedures, recovery is far quicker than recovery from open spine surgery. After radiofrequency ablation, it's normal to feel some soreness at the treatment site for a few days; most people return to light, everyday activity quickly and simply ease back from strenuous exertion during the first week. The pain-relieving effect builds gradually over the following couple of weeks as the treated nerves settle, so the full benefit isn't instant — it arrives as the soreness fades.

Recovery from a spinal cord stimulator is similar in spirit: the trial requires no real downtime, and after a permanent implant you'll follow some simple activity precautions for a short period while everything heals. You'll leave with clear, written aftercare instructions, and we see you in follow-up to fine-tune the device and make sure you're getting the most from it. Whatever the procedure, the plan is built around your life and the activities you want to get back to.

Insurance, Out-of-Network & Cost

We welcome out-of-network patients of every kind and you don't need a referral to be seen. Our team verifies your coverage and explains any out-of-pocket costs before anything is scheduled, so there are no surprises. Because many of our patients come to us after a car accident or injury, we also coordinate closely with personal-injury attorneys and offer 24/7 concierge support for accident-related spine and pain care. If you've been putting off treatment because you're unsure what insurance will cover, that uncertainty shouldn't stand between you and relief — a quick call to our team is the fastest way to get clear answers before you commit to anything.

Proudly Serving the Greater Phoenix, Arizona Area

Why Choose Our Specialists in Phoenix

These advanced procedures are performed by a dual board-certified spine surgeon and neurosurgeon — the right level of expertise for treatments that work directly with the nerves and spinal cord. We welcome out-of-network patients, require no referral, and coordinate with personal-injury attorneys.

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Ablation & Stimulation: Frequently Asked Questions