Radiofrequency Denervation (Facet Joint)

⚙️What This Procedure Involves

Under fluoroscopic (X-ray) guidance, a radiofrequency needle is placed adjacent to the medial branch nerve at each affected level (typically two nerves per joint — the level above and the level of the joint). The nerve is stimulated to confirm correct position (motor and sensory testing). Local anaesthetic is injected around the nerve. A radiofrequency current is then applied, heating the nerve tip to 80°C for 60–90 seconds, destroying the nerve's ability to transmit pain. Multiple levels are usually treated. The procedure takes 30–60 minutes.

💡Why It May Be Recommended

RFD is recommended for chronic facet joint pain that has been confirmed by at least two successful diagnostic medial branch block injections providing at least 50–80% temporary relief. It is used for cervical and lumbar facet joint pain.

⚖️Non-Operative Alternatives

Physiotherapy, oral medication, medial branch block injections (shorter duration of relief), facet joint injections, and activity modification.

📋Preparing for Surgery

Diagnostic medial branch blocks must have been performed on at least two occasions with consistent, significant relief. Informed consent regarding the temporary nature of the relief.

✅Expected Benefits

Pain relief lasting typically nine to eighteen months (sometimes longer). Approximately 60–70% of carefully selected patients achieve significant benefit. The procedure can be repeated when the nerves regenerate and pain returns.

⚠️Common Risks

• Post-procedure sorenessExpected

  Back or neck ache at the treatment sites for one to two weeks.

• Temporary flareCommon

  Pain may temporarily worsen before improving.

• Incomplete reliefCommon

  Not all patients achieve adequate benefit.

🔴Less Common but Serious Risks

• Nerve injuryRare

  Unintended damage to a spinal nerve root — very rare with proper technique.

• InfectionRare

  At the needle sites.

• NeuritisUncommon

  Temporary inflammation of the treated nerve causing increased pain for two to four weeks.

• Skin burnRare

  Extremely rare with modern equipment.

• Motor nerve damageRare

  Very rare if the needle is malpositioned.

💉Anaesthetic Considerations

Local anaesthetic with mild sedation. The patient must be awake enough to report symptoms during nerve stimulation testing.

🏃Recovery and Rehabilitation

Most patients go home the same day. Avoid heavy activity for 48 hours. The full benefit may take two to six weeks to develop as inflammation settles. If successful, the relief typically lasts nine to eighteen months before the nerves regenerate.

📅Follow-Up

Review at six to eight weeks to assess response. Repeat RFD when pain returns (nerves regenerate over months).

❓Frequently Asked Questions