Radiofrequency ablation (RFA) uses controlled thermal energy to interrupt pain transmission through selected sensory nerves, most commonly the medial branch nerves supplying painful facet joints.
For facet-mediated neck or low back pain, RFA targets the medial branch nerves that carry pain signals from the facet joints. Diagnostic medial branch blocks are generally used first to confirm that the facet joints are a significant pain source.
Candidacy depends on the diagnosis, prior treatment, examination, imaging when appropriate, medical history, and the expected risk-benefit profile.
Predominantly axial neck or low back pain consistent with facet-mediated pain
Appropriate response to diagnostic medial branch block(s)
Persistent symptoms despite reasonable conservative care
No alternative diagnosis better explaining the dominant pain pattern
Clinical evaluation for facet-mediated pain
Diagnostic medial branch block(s)
Image-guided placement of radiofrequency cannulae
Thermal lesioning of the selected medial branch nerves
Potential risks include temporary soreness, neuritis or burning pain, numbness, bleeding, infection, allergic reaction, unintended nerve injury, and incomplete or temporary relief. Nerves can regenerate, so benefit is not necessarily permanent.
Results vary, and no procedure can guarantee pain relief or functional improvement.