What is radiofrequency denervation of cervical facet joints?

Radiofrequency Denervation (also known as Radiofrequency Ablation or Rhizolysis) is a
procedure used to reduce chronic neck pain caused by arthritis or inflammation in the
cervical facet joints — the small stabilising joints located at the back of the neck. It involves
applying controlled heat to the small nerves (medial branch nerves) that transmit pain from
these joints, effectively interrupting the pain signals.

What conditions do we offer this for?

This procedure is offered to patients with:

  • Well-localised chronic neck pain due to cervical facet joint arthritis
  • One-sided cervical facet joint syndrome, confirmed through previous diagnostic medial branch blocks
  • Neck stiffness or pain worsened by turning, tilting, or extending the neck

Why is it done?

Radiofrequency Denervation of cervical facet joints aims to:

  • Provide longer-lasting pain relief (typically 6–12 months or longer)
  • Reduce the need for ongoing pain medications
  • Improve neck mobility, sleep quality, and daily functioning
  • Support engagement in physiotherapy or active rehabilitation
    It is typically considered only after a positive response to diagnostic nerve blocks.

What does the procedure involve?

  • You will lie on your front or side depending on the location of neck pain
  • The skin is cleaned and numbed with local anaesthetic.
  • Using X-ray or ultrasound guidance, a fine needle is placed close to the target nerve.
  • A small electrical current is used to confirm correct positioning — you may feel a mild tingling or tapping sensation.
  • Radiofrequency energy is then delivered at the tip of the needle, which heats up the nerve.
  • The procedure typically takes 45–60 minutes and is done as a day case.

Benefits

  • Targeted pain relief without need for invasive surgery
  • Reduced reliance on pain medications
  • Improved function, posture, and physical activity
  • May delay or avoid the need for surgery

Side Effects

Very Common side effects

(may affect more than 1in 10 patients):
  • Pain or bruising at the needle site
  • Temporary increase in neck pain
  • Mild numbness or tingling in the neck or shoulder

Common side effects

(may affect up to 1in 10 patients):
  • Temporary muscle spasms or cramping around the treated area.
  • Localised swelling, tenderness, or discomfort at the injection site, which usually settles within a few day.

 Uncommon side effects

(may affect up to 1 in 100 patients):
  • Mild skin burn or superficial infection
  • Temporary numbness in nearby skin areas

 Rare side effects

(may affect up to 1 in 1,000 patients):
  • Persistent numbness or nerve injury
  • Allergic reaction to local anaesthetic or antiseptic
  • Bleeding or haematoma formation
  • Temporary dizziness or unsteadiness

Aftercare Advice

  • You will be monitored after the procedure and discharged the same day.
  • Avoid driving for 24 hours.
  • Mild soreness in the neck is common and may last for several days to a couple of weeks — ice packs and simple painkillers can help.
  • Resume activities gradually; gentle stretching or physiotherapy is often advised.
  • Avoid heavy lifting or vigorous exercise for a few days unless advised otherwise.
  • If the procedure provides meaningful benefit, it can be repeated when the pain returns. However, the same level or duration of pain relief cannot be guaranteed with repeat denervation, and some patients may experience a shorter or less effective response over time.

When to Seek Medical Attention

Please attend A&E immediately if you experience:
• Fever, chills, or signs of infection at the injection site
• New or worsening numbness or weakness in the limbs
• Difficulty with coordination, speech, or vision
• Severe or persistent pain not relieved by your usual medication