Cervical Radiofrequency Ablation

WHAT ARE CERVICAL FACET JOINTS?

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. The right C2-3 facet joint, for example, joins the 2nd and 3rd vertebrae on the right side. Facet joints not only connect the vertebrae, but they also guide the spine during movement. Medial branch nerves, located near facet joints, communicate pain from the facet joints. In other words,  these nerves tell the brain when a facet joint has been injured.

WHAT IS CERVICAL FACET JOINT PAIN?

Cervical facet joint pain is a result of injury, either to the cartilage inside the joint or the connecting  ligaments surrounding the joint. Pain from an injured cervical facet joint may range from muscle tension to more severe pain. Depending on which facet joint is affected, the pain may occur in an area from your head down to your shoulder blade. The diagram shows areas of pain usually associated with specific joints.

HOW DO I KNOW IF I HAVE CERVICAL FACET PAIN?

If you have pain in one or more of these areas, and it has lasted longer than two months, you may have  cervical facet pain. Common tests such as x-rays or MRIs may not always show if a facet joint is the reason for your pain. The best way to diagnose facet pain is to block the pain signal in a medial branch nerve.

WHAT IS A CERVICAL RFA?

During this procedure, radiofrequency energy is used to disrupt function of a cervical medial branch nerve, so that it can no longer transmit pain signals from an injured facet joint.

WHAT HAPPENS DURING AN RFA?

An RFA may start with an IV (medicine given intravenously) to help you relax. A local anesthetic may be  used to numb your skin. The doctor will then insert a thin needle near the facet joint. Fluoroscopy, a type of x-ray, will be used to  position the needle. The doctor will then check that the needle is in the proper position by stimulating the nerve. This may cause muscle twitching and provoke some of your pain. With the needle in the correct position, the area will be numbed. Your doctor will then use radiofrequency  energy to disrupt the medial branch nerve.

WHAT HAPPENS AFTER AN RFA?

You will be monitored for up to 30 minutes after the injection. Before you leave, the clinic will give you discharge instructions as well as a pain diary. Keeping track of your pain helps the doctor know  what the next step will be. You may feel sore for one to four days. This is normal, and may be caused by muscle and nerve irritation. Your neck or upper back may feel numb, weak, or itchy for a couple of weeks. Be patient,  as full pain relief normally takes two to three weeks.

HOW LONG CAN I EXPECT PAIN RELIEF?

Nerves regenerate after an RFA, but how long this takes varies. Your pain may or may not return when the  nerves regenerate. If it does, another RFA can be done.

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