Radiofrequency Ablation (RFA): Lasting Relief for Facet Joint Pain

If you’ve had significant relief from medial branch nerve blocks but the pain later returned, your doctor may recommend Radiofrequency Ablation (RFA).

This minimally invasive procedure uses precisely directed heat energy to gently deactivate tiny pain-carrying nerves in the spine offering longer-lasting relief from facet joint arthritis or chronic low-back and neck pain.

Why It’s Done

Facet joints can become painful from arthritis or degeneration. The medial branch nerves that transmit these pain signals can be safely and temporarily interrupted using RFA.

RFA is most often recommended for:

• Confirmed facet joint pain following successful diagnostic nerve blocks

• Chronic back or neck pain that worsens when standing or twisting

• Patients seeking to avoid long-term medication or repeated injections

How the Procedure Works

• Preparation – The procedure is performed in a sterile, outpatient setting under fluoroscopic (X-ray) guidance. Local anesthesia is used to numb the skin.

• Needle Placement – Thin specialized needles are positioned precisely near the targeted medial branch nerves.

• Testing – Mild stimulation confirms the correct nerve location.

• Ablation – Radiofrequency energy gently heats the nerve for 60–90 seconds, interrupting its ability to carry pain signals.

The procedure typically takes 30–45 minutes, and patients return home the same day.

What to Expect Afterward

• Temporary soreness or muscle tightness for a few days

• Gradual onset of pain relief over 1–3 weeks

• Full benefit often realized within one month

• Relief can last 6–12 months, sometimes longer, until nerves naturally regenerate

Normal activities may resume within a day, though heavy exertion should wait 48 hours.

Safety and Risks

Radiofrequency ablation is extremely safe when performed under image guidance.

Potential—though rare—effects include:

• Temporary numbness or localized burning sensation

• Mild swelling or bruising at needle sites

• Rare infection or nerve irritation

Because the targeted nerves only carry pain signals (not strength or movement), there’s no risk of paralysis or muscle weakness.

When to See a Specialist

If you’ve had temporary relief from facet or medial branch blocks but pain keeps returning, Radiofrequency Ablation may be the next step toward longer-lasting comfort and improved function.