Cervical Medial Branch Radiofrequency Denervation

This procedure is performed by using radiofrequency energy to disrupt the function of nerves that supply the facet joints in the neck.  The purpose of this procedure is to stop pain from the cervical facet joints for usually about a years time.  

This procedure is performed when the patient is lying with their face down on a special pillow.  This pillow holds the neck straight during the procedure.  Small needles are placed on top of the nerve with specialized tips that heat up and disable its function. When successful this procedure can be repeated when the pain returns without needing to have the test injections again.

The first step we must take before you are considered a candidate for a radiofrequency ablation procedure is two sets of diagnostic nerve blocks. This involves injecting a small amount of local anesthetic medication at the sites of the nerves. We expect to see a few hours of pain relief after these injections, and if this is achieved after two sets of nerve blocks, we may then move forward with the ablation procedure.


What is the recovery going to be like?

Oftentimes, patients are sore for the first couple of days after the procedure. Occasionally this soreness can last as long as a couple of weeks. This is typically manageable with ice, ibuprofen, or Tylenol.

How long does it last?

Patients can expect 6-12 months of pain relief from the procedure. Eventually, the nerves we ablate do grow back, and if your pain returns, we may discuss repeating the procedure at that time.

Will this cure my back or neck pain?

The goal of this procedure is to eliminate the majority of the pain coming from the arthritis in your neck or back. It will not cure the arthritis, but will reduce your ability to feel pain from the arthritic joints.

How often can I have this procedure done?

Every six months, but we hope to obtain even longer lasting relief than this.

You are “burning” my nerves. Will it hurt?

We use a generous amount of local anesthetic to numb the area prior to any ablation. This procedure is generally very well tolerated.

Pre Injections Instructions

If you are anxious about your procedure, sedation may be an option for you.
If your plan of care involves sedation, you must meet the following criteria:


Come to your appointment with a responsible adult driver.


Fast for at least 6-8 hours prior to our appointment time. Morning medications can be taken with a sip of water no later than 2 hours prior to you appointment time. Exceptions may include diabetic medications, in this case please call the office for specific instructions.


If you are taking blood thinners or supplements, we may ask that you discontinue them prior to your procedure. Never stop these medications without approval from the physician prescribing them.

If you are taking blood thinners your pain physician may ask they be discontinued prior to injection.  Never stop these medications without permission from the physician prescribing them. Please call our office if your blood thinner is not listed:

  • Acenocoumarol
  • Agggrenox
  • Aggrastat   
  • Arixtra
  • Aspirin
  • Brilinta
  • Edoxaparin
  • Effient
  • Eliquis
  • Heparin
  • Integrilin
  • Lovenox
  • Pentoxil
  • Plavix
  • Pletal 
  • Pradaxa
  • ReoPro
  • Ticlid
  • Warfarin/Coumadin
  • Xarelto

If you are taking any supplements such as Fish Oil, Garlic, Ginseng, Vitamin A&E, Ginger, Kava Kava, Clove, White Willow bark, or Gingko please stop these 7 days prior to your procedure.

Start the Path Towards Healing

Our physicians offer ​diagnostic testing, fluoroscopic guided procedures and steroid injections. Our goal is to restore function of damaged joints, nerves, and muscles to treat low back, neck, and other pain. Our mission is to have all patients living their lives with minimal pain and to meet each of our patients’ needs with the highest quality care. We offer innovative solutions utilizing the latest, minimally invasive technologies.