The dorsal root ganglion (DRG) is a cluster of nerve cells just outside your spinal cord that relays pain signals from a specific area of your body. Pulsed radiofrequency (pulsed RF) applies short bursts of energy to calm this relay point without destroying it, aiming to reduce pain in the area it supplies, though individual results vary.

This procedure may help if you have:

• Persistent nerve-related (radicular) pain in a specific, well-defined distribution
• Pain not settling with physiotherapy, medication, or other conservative treatment
• A positive response to a prior diagnostic block confirming this nerve as a pain source

It isn't possible to guarantee how any individual will respond. As a general guide:

• Pulsed RF: effect usually begins after a couple of weeks, continues to improve over the first month or two, and may last for a few months, sometimes longer.

This procedure is generally considered safe when performed under X-ray guidance, though as with any medical procedure benefit cannot be guaranteed and complications rarely occur. Pulsed RF modulates the nerve rather than destroying it, which is particularly relevant near the DRG given its role in normal sensation.

Common, minor effects:

• Temporary soreness at the injection site for a day or two
• Brief flare of your usual pain before it settles

Rare, more serious risks:

• Infection or bleeding at the injection site
• Nerve injury, which may rarely be permanent
• Allergic reaction to the local anaesthetic or contrast dye
• Small increased lifetime risk from the X-ray exposure used to guide the procedure
• Serious sedation or anaesthetic complications, very rarely including stroke or death
• No improvement in pain, or relief that doesn't last

• Tell us about any blood-thinning medication (e.g. warfarin, Xarelto, Plavix) well in advance — special arrangements may be needed and you may be asked to pause these under guidance
• Tell us if you are, or might be, pregnant — this procedure uses X-ray guidance
• Tell us about any allergies, including to contrast dye, local anaesthetics, or reactions to previous injections or anaesthesia
• You will usually be asked to fast for 6 hours beforehand if sedation is planned
• Bring a list of your current medications
• Arrange for someone to drive you home afterwards

• The skin over the treatment area is cleaned with antiseptic
• Local anaesthetic numbs the skin before the main needle is placed
• Live X-ray (fluoroscopy) guides the needle precisely to each target
• A brief stimulation test checks the needle is correctly positioned
• The procedure usually takes 30-45 minutes

• You will be monitored briefly in recovery before going home
• Some soreness at the injection sites is common for 1-3 days — simple pain relief (e.g. paracetamol) usually helps
• You may remove the small dressing after 24 hours, keeping the area clean and dry
• Avoid strenuous activity or heavy lifting for 24-48 hours
• If you were sedated, avoid driving, operating machinery, or making important legal or financial decisions for 24 hours
• Continue your regular medications unless specifically advised otherwise

Contact your GP, Total Pain Clinic, or your nearest Emergency Department if you notice:

• Increasing redness, swelling, or discharge at the injection site
• Fever or feeling generally unwell
• New weakness, numbness, or loss of bladder/bowel control
• Severe pain not settling with simple pain relief

A review appointment is usually arranged 2-4 weeks after your procedure to discuss how you responded and plan next steps — please call Total Pain Clinic reception to schedule this if it hasn't already been arranged. Please ask your doctor any questions before you proceed; you will be asked to sign a consent form if you agree to go ahead.