Cervical Facet RFA
If cervical facet blocks have confirmed that your neck pain or headache is coming from the facet joints, RFA is the next step. It ablates the pain-carrying nerves to the joints, and can keep the pain away for up to two years.
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Frequently asked questions
What is Cervical Facet RFA?
Cervical Facet RFA uses radiofrequency energy to ablate the medial branch nerves that supply the cervical facet joints. Each facet joint is innervated by two medial branches from the dorsal rami. By ablating these small nerves, the pain signal from the arthritic or inflamed facet joint is interrupted at its source. Relief typically lasts 12–24 months, significantly longer than an injection.
Who is suitable for Cervical Facet RFA?
Patients who have had a positive cervical medial branch block (each giving ≥50% or more pain relief) are suitable candidates for RFA. Ideally, the block is done on a separate visit to confirm a consistent and reproducible response. This careful diagnostic pathway ensures RFA is used only for patients most likely to benefit.
Which neck conditions benefit most from Cervical Facet RFA?
The procedure is most effective for chronic axial neck pain from cervical spondylosis (arthritis), cervicogenic headache originating from the upper cervical facets (C2–C3), and whiplash-related facet pain that has persisted beyond 6–12 weeks. It is not intended for pain caused by disc herniation pressing on a nerve root, that is a different pain mechanism.
How is Cervical Facet RFA performed?
You lie face-down on the fluoroscopy table. Under live X-ray guidance, RF cannulas are placed at the articular pillars of the cervical spine, one for each medial branch nerve being targeted. Sensory stimulation at 50Hz confirms nerve proximity (you may feel familiar pain or buzzing); motor stimulation at 2Hz checks that no motor nerve is in the path. Local anaesthetic is given, then RF energy is applied to each probe for 60–90 seconds. Several levels may be treated in a single session. Total time: 30–45 minutes.
When will I feel better after Cervical Facet RFA?
Expect mild neck soreness and stiffness in the first 1–2 weeks. This is the normal tissue response to heat. Pain relief begins building from 2–4 weeks as the ablated nerves stop transmitting pain. Full benefit is typically realised at 6–8 weeks. Many patients describe a gradual lifting of their baseline pain over this period.
Are there any risks to nerve function from Cervical Facet RFA?
The medial branch nerves targeted in Cervical Facet RFA are purely sensory nerves that supply the facet joints. They do not control movement. Motor stimulation testing before ablation ensures that no motor nerve is inadvertently ablated. Some patients experience a small patch of skin numbness near the procedure site. This is typically temporary. Serious complications are rare.
What happens when neck pain returns after Cervical Facet RFA?
Medial branch nerves can regenerate over time, usually after 12–24 months. If your pain returns and follows the same pattern, a repeat RFA is safe and well tolerated. Many patients go through several successful cycles over the years, maintaining an active, pain-free lifestyle without surgery.
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