If you have thyroid nodules causing neck pain or impacting your ability to speak, breathe, or swallow, your endocrinologist may prescribe RFA treatment. Radiofrequency ablation (RFA) is a minimally invasive procedure used as an alternative to surgery to address benign thyroid nodules.

What is Radiofrequency Ablation?

The RFA procedure uses radiofrequency waves to create an alternating current oscillating between 200 kHz and 1200 kHz. This current heats the tips of a thin needle placed inside the nodule. The heat destroys the abnormal thyroid tissue and stops it from growing while leaving the healthy tissue undamaged.

RFA treatment is also often used as part of a physical therapy program to treat nerve pain or joint pain. The high destroys the target nerve to provide pain relief for chronic pain conditions like arthritis.

How to Prepare for RFA Treatment

Before your procedure, your doctor may give you some instructions to follow so you can prepare. If you take blood-thinning medications like warfarin, dabigatran, or aspirin, you’ll need to significantly reduce your dosage or stop taking the medication for several days before the procedure.

You should wear light, loose-fitting clothing, including shorts or a skirt and a top with a low neckline to allow your doctor to access your throat. Remove any jewelry or piercings.

Although you do not need to be sedated, it is a good idea to organize for someone you trust to drive you home after the procedure.

On the day of the RFA treatment, you should avoid eating or drinking for at least six hours before the procedure. If you need to take essential medications, you can take them with a sip of water up to two hours before your treatment is due to begin.

What to Expect During the RFA Treatment

The entire procedure takes between 15 and 60 minutes, depending on the size and number of thyroid nodules. The doctor attaches two grounding pads to your thighs, then directs you to lie on the table on your back with your head and shoulders on a pillow.

Injecting anesthesia

Unlike thyroid surgery, which typically requires sedation via an intravenous (IV) line, thyroid RFA is performed under local anesthesia. Your doctor applies a small amount of numbing gel to the injection site and inserts a thin needle with a local anesthetic under the skin.

This ensures that you are fully conscious throughout the procedure, allowing you to converse and respond with your doctor while ensuring you are completely comfortable.

The thyroid gland has no pain receptors so that you won’t feel any discomfort. However, a small percentage of people (approximately 2-3%) experience a mild, temporary burning sensation when the radiofrequency generator is activated and delivers energy to the needle.

If you experience discomfort, your doctor can stop the treatment and inject more anesthetic.

Injecting anesthesia

Inserting the electrode needle

The doctor applies an ultrasound transducer to your neck to create images to guide the needle to the correct location. The doctor may also move the needle around your thyroid gland without disengaging the radiofrequency generator.

This is known as the Moving Shot technique and is often used for large thyroid nodules. The doctor positions the electrode inside the deepest part of the nodule and gradually moves it forward, ablating the nodule unit by unit.

Another common technique used is the transisthmic approach. The electrode is inserted into the lateral part of the isthmus (the tissue bridge connecting the two thyroid lobes).

This allows the doctor to see the entire length of the electrode via ultrasound and minimizes heat damage to healthy thyroid tissue, laryngeal nerve, and esophagus.

Removing the electrode

After the abnormal thyroid tissue is ablated, the doctor removes the electrode slowly and applies a bandage to your neck. You may experience mild swelling, bruising, or bleeding around the insertion site; however, these symptoms should subside after 48 hours.

You’ll need to schedule follow-up exams at six weeks, six months, and 12 months so your doctor can evaluate your progress and determine whether further treatments are required.

They can also assess your thyroid function to ensure that hypothyroidism doesn’t occur, which can be a side effect in around 8 to 12% of high-risk patients with diabetes or low TSH levels pre-treatment.

Schedule a Consultation With Associated Endocrinologists

If you experience symptoms of hyper- or hypothyroidism or notice a visible lump around your thyroid, contact Associated Endocrinologists for an appointment with one of our experienced healthcare professionals.

We are happy to answer any questions you have about radiofrequency ablation and our other treatments.

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