What is the difference between ablation and steroid injections?

October 9, 2025 •

4 min read

According to studies, millions of people worldwide suffer from chronic pain, often requiring intervention to manage their condition. When considering treatment options, patients often face a choice between procedures like ablation and steroid injections, each with distinct mechanisms, durations, and applications.

Quick Summary

Ablation uses energy to disrupt nerve signals, providing long-term pain relief by targeting the source of the pain. Steroid injections use anti-inflammatory medication to reduce swelling and provide temporary relief. The best choice depends on the specific condition, pain type, and treatment goals.

Key Points

Ablation Interrupts Pain Signals: Ablation uses heat or cold to intentionally disrupt specific nerve pathways, blocking pain signals from reaching the brain.
Steroid Injections Reduce Inflammation: Steroid injections deliver potent anti-inflammatory medication directly to the source of pain, calming swelling and irritation.
Ablation Offers Longer Relief: Pain relief from ablation typically lasts much longer than from steroid injections, often for many months.
Onset and Duration Differ: Steroid injections may provide noticeable relief within a day or two, but the effect is temporary. Ablation relief may take a week but is more durable.
Common Treatment Progression: Many patients try steroid injections first. If successful but temporary, ablation may be used as a next step for more lasting relief.
Conditions Treated Vary: Ablation targets nerve-related pain, while steroid injections treat pain from inflammation in joints, tendons, and bursae.

How Ablation Works for Chronic Pain

Ablation, particularly radiofrequency ablation (RFA), is a minimally invasive procedure that uses an electrical current to create a high-frequency heat wave. This heat is used to destroy or inactivate specific nerve tissues that transmit pain signals to the brain. The procedure is often performed using X-ray or ultrasound guidance to ensure the precise placement of a needle or catheter to the target nerve.

The Ablation Procedure

During an ablation procedure, a local anesthetic is typically used to numb the area. A thin, hollow needle is guided to the targeted nerves. Once in position, the radiofrequency current is delivered through the needle, effectively 'burning' the nerve and blocking pain signals. The process is relatively quick, often taking 15 to 30 minutes, and patients can typically return home the same day.

Conditions Treated by Ablation

Chronic back and neck pain: Often targeting the facet joints.
Sacroiliitis: Inflammation of the sacroiliac joints.
Spondylosis: Degenerative changes in the spine.
Certain types of nerve-related pain: Including pain in areas like the knee.

How Steroid Injections Work for Pain Relief

Steroid injections, also known as cortisone shots, involve delivering a corticosteroid directly into an inflamed area. The medication is a powerful anti-inflammatory that works by suppressing the immune system's inflammatory response. By reducing inflammation, the pressure on nerves and surrounding tissues decreases, which in turn alleviates pain.

The Steroid Injection Procedure

Similar to ablation, steroid injections are performed with a needle, and imaging guidance (like ultrasound or fluoroscopy) may be used to ensure accuracy. The injection often includes both the steroid medication and a local anesthetic. The numbing agent provides immediate, though short-lived, pain relief, while the steroid medication takes several days to become fully effective.

Conditions Treated by Steroid Injections

Arthritis: In joints like the knee, hip, and shoulder.
Tendinitis: Inflammation of a tendon.
Bursitis: Inflammation of the fluid-filled sacs that cushion joints.
Sciatica: Nerve pain caused by a compressed nerve in the lower back.
Carpal Tunnel Syndrome: Nerve compression in the wrist.

Ablation vs. Steroid Injections: A Comparison


Feature	Ablation (e.g., Radiofrequency)	Steroid Injections (e.g., Cortisone)
Mechanism	Uses heat or cold energy to interrupt pain signals from nerves.	Delivers anti-inflammatory corticosteroids to reduce swelling and calm the immune response.
Pain Type	Typically targets specific nerves causing chronic, longer-term pain.	Addresses pain caused by localized inflammation, often used for acute flares or chronic inflammatory conditions.
Duration of Relief	Provides longer-lasting relief, potentially from several months to over a year.	Offers temporary relief, usually lasting from weeks to a few months.
Onset of Action	Can take a few days to a week for the full effect to be felt.	Initial numbing relief is immediate, but steroid effect takes 24-48 hours to begin working.
Risk of Side Effects	Risks include temporary soreness, bruising, nerve damage, or infection.	Risks include temporary pain flare, bruising, skin discoloration, flushing, and temporary blood sugar elevation.
Repeat Frequency	Can be repeated, but typically only after the pain returns months later.	Limited frequency to avoid side effects; typically no more than a few times per year in one area.

How to Choose Between Ablation and Steroid Injections

The decision between ablation and steroid injections is a highly individualized one that should be made in consultation with a healthcare provider, such as a pain specialist or physiatrist. Often, a patient's treatment journey begins with more conservative measures. A common progression is to first use steroid injections to confirm the source of the pain and provide temporary relief. If the injections are effective but the relief is short-lived, an ablation may be the next step for longer-lasting results.

Your doctor will consider several factors when making a recommendation:

The underlying cause of your pain: Is it primarily inflammatory or nerve-related?
The location and type of pain: Is it a deep-seated, chronic nerve pain or more of an acute, inflammatory joint issue?
Your medical history and previous treatments: Have you tried injections or other conservative therapies before?
Long-term goals: Do you need short-term relief to facilitate physical therapy or are you seeking a longer-term solution?

An experienced medical provider will weigh these considerations to determine the most appropriate and effective treatment plan. For more detailed information on specific procedures, resources like the Mayo Clinic can provide further guidance on pain management therapies.

Conclusion

Ablation and steroid injections offer effective, minimally invasive approaches to managing chronic pain, but they differ fundamentally in their mechanism and duration of effect. Steroid injections focus on short-term inflammation reduction, providing temporary relief. Ablation, in contrast, aims for longer-lasting results by disrupting the pain-signaling nerves. The best choice is determined by the specific diagnosis and pain characteristics, and is typically part of a comprehensive pain management strategy decided upon with a healthcare professional.

Frequently Asked Questions

Both ablation and steroid injections are considered minimally invasive, non-surgical procedures. Ablation is often slightly more involved as it involves intentionally damaging nerve tissue, but both are performed with needles and imaging guidance.

Pain relief from a steroid injection typically lasts anywhere from a few weeks to several months. In contrast, relief from an ablation can last for several months to a year or even longer.

Steroid injections work by decreasing inflammation, which in turn reduces pain. Ablation works by disabling the specific nerves that send pain signals to the brain, directly interrupting the pain pathway.

Yes, a doctor may use steroid injections as a diagnostic tool. If an injection provides short-term relief, it helps confirm the nerve is the pain source. An ablation may then be recommended for longer-term relief.

Common side effects of ablation include temporary soreness, bruising, and discomfort at the injection site. More serious complications like nerve damage or infection are rare.

Yes, steroid injections can cause temporary side effects such as a pain flare-up in the first day or two, facial flushing, skin discoloration, and, for diabetics, a temporary increase in blood sugar levels.

The best treatment depends on the specific cause of your pain. A pain management specialist can assess your condition, diagnose the source of the pain, and recommend the most suitable option, considering your overall health and goals.