A cervical radiofrequency ablation (RFA) is a procedure for treating neck, shoulder, and upper body pain.  It is also called cervical facet thermal coagulation or rhizotomy.  

What are cervical facet joints?

Facet joints connect the vertebrae, the bones of the spine.  They help guide your spine when you move.  The neck area of the spine is called the cervical region.  It contains seven vertebrae.  Facet joints are found on both sides of the spine.  Each is about the size of a thumbnail.  Cervical facet joints are named for the vertebrae they connect and the side of the spine where they are found.  Medial branch nerves are found near facet joints.  They communicate pain from the facet joints.  They tell the brain when a facet joint has been injured.

What is cervical facet joint pain?

You may feel pain if a cervical facet joint is injured.  Sometimes it feels like simple muscle tension.  Other times it can be severe pain.  The cartilage inside the joint may be injured.  Other times only connecting ligaments surrounding the joint are injured.  Facet joint pain also depends on which joint is affected.  Cervical facet joint pain can occur in an area from your head down to your shoulder blade.  

How do I know if I have cervical facet pain?

If you have pain in one or more of these areas, and it lasts longer than two months, you may have cervical facet pain.  The best way to diagnose facet pain is to block the pain signal in a medial branch nerve.

What is cervical RFA?

RFA uses radiofrequency energy to disrupt nerve function.  When this is done to a cervical medial branch nerve, the nerve can no longer transmit pain from an injured facet joint.  

What happens during the RFA procedure?

An RFA usually starts with an IV to help you to become relaxed.  A local anesthetic may be used to numb your skin.  The physician will then insert a thin needle near the facet joint.  Fluoroscopy, a type of x-ray, will be used to position the needle.  The physician will then check to see if it is at the correct nerve by stimulating it.  This may cause muscle twitching and provoke some pain.  Once the needle is correctly placed, the area will be numbed.  Radiofrequency energy will then be used to disrupt the medial branch nerve.  This is often repeated at more than one level of the spine.

What happens after the RFA procedure?

You will be monitored for up to thirty minutes following the RFA procedure.  When you are ready to leave, the clinic will give you discharge instructions.  You will also be advised to keep a pain diary.  It is important for you to keep a log in this diary to help your physician know how the RFA is working for you.  You should plan to rest for the remainder of the day.  You may feel sore for one to four days.  This is normal.  It may be due to muscle and nerve irritation.  Your neck may feel numb, weak, or itchy for a couple of weeks following the procedure.  Full pain relief normally comes in two to three weeks.

How long can I expect pain relief?

Nerves regenerate after an RFA, but how long it takes them to do so may vary from person to person.  Your pain may or may not return when the nerves regenerate.  If it does another RFA can be scheduled.