What is cervical radiofrequency ablation (RFA)?
Cervical radiofrequency ablation is a minimally invasive procedure that uses heat generated by radio waves to temporarily disrupt the small nerves (medial branch nerves) that carry pain signals from painful facet joints in your neck to your brain. It is commonly used to treat chronic neck pain, cervicogenic headaches, and whiplash-related pain when conservative treatments have failed.
Am I a candidate for cervical RFA?
You may be a candidate if:
- You have chronic neck pain lasting more than 3–6 months
- Facet joint pain has been confirmed by diagnostic medial branch blocks (you experienced ≥70–80% pain relief after block)
- You’ve already tried physical therapy, medications, and possibly injections without lasting relief Your pain specialist will determine eligibility after reviewing your history and diagnostic block results.
How should i prepare for the procedure?
- Stop blood-thinning medications (aspirin, Plavix, Coumadin, Eliquis, etc.) as instructed (usually 5–10 days prior)
- Arrange for someone to drive you home (you cannot drive the day of the procedure if you are receiving sedation)
- Do not eat or drink after midnight the night before if IV sedation is planned
- Wear comfortable clothing and arrive 30–60 minutes early
How are the Procedures done?
You’ll lie face-down on an x-ray table. The skin is numbed with local anesthetic. Using live x-ray (fluoroscopy) guidance, the doctor places thin needles next to the targeted medial branch nerves. A small electrical current first confirms correct placement (you may feel tingling or muscle twitching in your neck/shoulders). The nerves are then heated to 80–90°C for 60–90 seconds each. The entire procedure usually takes 15–30 minutes.
How long does pain relief last?
On average, relief lasts 9–18 months (sometimes longer). When the nerves regenerate, pain can gradually return, but the procedure can be safely repeated if diagnostic blocks again confirm benefit.
Is the procedure painful?
Most patients feel pressure or a brief burning sensation when the local anesthetic is injected into the skin, but the procedure itself is generally well-tolerated. We can provide mild sedation (oral or IV) if you are very anxious.
What should i expect right after the procedure?
- You’ll rest in recovery for 20–45 minutes
- Your neck will feel numb and possibly weak or “heavy” for a few hours
- Mild soreness or a sunburn-like feeling at the needle sites is common for 1–2 weeks
- You may notice a temporary increase in pain for the first 1–3 weeks as the nerves “cool down”
When will I notice pain relief?
Pain relief typically begins 1–3 weeks after the procedure once post-procedure soreness settles. Maximum benefit is usually seen by 4–6 weeks.
Do I need a driver?
Yes. Sedation is commonly used, and if used an adult is required to take you home. Also with sedation you are to fast for 8 hours prior to the appointment.
Will I have any restrictions after the procedure?
- No driving or operating machinery for 24 hours
- No soaking baths or swimming for 48–72 hours
- Light activity the first few days; gradually resume normal activities as tolerated
- Avoid heavy lifting or strenuous neck motion for 1–2 weeks
What are the risks and side effects?
Cervical RFA is very safe, but possible risks include:
- Temporary soreness or bruising at needle sites
- Temporary numbness or tingling in the scalp, shoulders, or arms
- Rare infection, bleeding, or nerve injury
- Very rare risk of allergic reaction to local anesthetic Overall serious complication rate is <1 in 1,000 procedures.
Are there any contraindications?
Yes. The procedure is typically not performed if you have:
- Active infection or fever
- Bleeding disorder or taking blood thinners (some can be held)
- Uncontrolled diabetes or congestive heart failure
- Allergy to contrast dye or local anesthetics
- Pregnancy
