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Neck radiofrequency ablation Who it helps, how the test block works, and what to expect on the day
Neck radiofrequency ablation (cervical RFA) uses gentle heat on the small medial branch nerves that carry pain from arthritic facet joints in the neck. It is for chronic neck pain, often with headaches or pain into the shoulder blades, that has lasted three months or more despite therapy and medicine. Two test blocks with numbing medicine come first; if they clearly relieve the pain, ablation can quiet those nerves for about six to twelve months, sometimes longer. It is done under imaging guidance through a thin needle, and most people go home the same day.
Many people with long-standing neck pain have “wear and tear” in the small facet joints at the back of the neck. The pain is often worse when looking up or turning the head, can spread to the shoulders or the base of the skull, and keeps coming back after physical therapy. Neck radiofrequency ablation targets the nerves that carry that pain, without surgery. The videos show the animation of the procedure and the test block that comes first.
Who neck radiofrequency ablation helps
- Chronic neck pain for three months or more from facet joint arthritis (cervical spondylosis); see spondylosis and facet joint pain
- Neck pain with headaches at the base of the skull (cervicogenic headache)
- Lasting neck pain after whiplash from a car accident; see car accident injuries and whiplash
- People who have tried physical therapy for neck pain, exercise and medicine without lasting relief
It is not the right treatment for pain that shoots down the arm from a pinched nerve; that pattern is usually a herniated disc in the neck and is treated differently, for example with an epidural steroid injection.
The test block comes first
Before ablation, your physician performs a medial branch block: a small amount of numbing medicine is placed next to the nerves of the painful facet joints under X-ray or ultrasound guidance. If your usual neck pain drops clearly for the hours the medicine lasts, those nerves are the source. Most plans repeat the block once to be sure. A good response to the blocks is the best predictor that cervical RFA will work.
What happens during neck radiofrequency ablation
- You lie face down or on your side, and the skin is cleaned and numbed
- Using imaging guidance, the physician places a thin needle with an electrode next to each target nerve
- A brief test confirms the position, then the nerve is numbed
- Gentle radiofrequency heat is applied for about a minute or two per nerve
- You rest briefly and go home the same day with a driver
The whole visit usually takes about an hour. Pain procedures are performed at all three offices, and your physician explains where and when yours will be scheduled.
Results and recovery
Soreness at the needle sites is common for a few days, and some people feel a sunburn-like sensitivity in the skin for a week or two. Relief usually builds over two to four weeks and can last six to twelve months or longer. The nerves slowly regrow, so the procedure can be repeated if the pain returns. Read our guide to radiofrequency ablation recovery for a week-by-week timeline, and use the pain-free window to build neck strength with stretches for neck pain.
Other treatments for chronic neck pain
Neck ablation is one part of a plan. Others include physical therapy (Brooklyn and Staten Island), cervical traction, trigger point injections and an EMG/NCV test when numbness or weakness suggests a nerve problem. For a full overview, see chronic neck pain treatment and our head and neck pain page.
More videos: the neck nerve block
More clips from our YouTube channel @precisioncaremedical showing the diagnostic block that comes before neck ablation.
Related care at Precision Care Medical & Sports Performance
Neck radiofrequency ablation near you
Looking for a neck pain doctor near me, or radiofrequency ablation near me? Precision Care Medical & Sports Performance evaluates chronic neck pain at all three offices, where our pain physicians, Ashley Marcus, MD in Brooklyn, Jake Stephen, DO on Staten Island and Yuri Gordin, MD in Manhattan review your imaging and decide whether medial branch blocks and ablation fit. In Brooklyn, our Brooklyn pain management office on Shell Rd serves Bensonhurst, Sheepshead Bay, Brighton Beach and Coney Island.
Our Staten Island pain management office on Richmond Rd is close to Todt Hill, Dongan Hills and New Dorp. In Manhattan, the Precision Care Spine & Pain Center in Midtown Manhattan is a direct ride from Washington Heights and Spanish Harlem. Request an appointment or call the office closest to you.
150 E 55th St, Suite 401, New York, NY 10022
(212) 840-0135
Questions patients ask
Is neck radiofrequency ablation painful?
The skin is numbed first, and most people feel pressure and some warmth. Soreness at the needle sites for a few days is common.
How long does neck radiofrequency ablation last?
Relief usually lasts six to twelve months and sometimes longer. Because the nerves slowly regrow, the procedure can be repeated if the pain returns.
Do I need a nerve block before neck RFA?
Yes. One or two medial branch blocks with numbing medicine confirm that the facet joint nerves carry your pain before ablation is planned.
Can neck radiofrequency ablation help headaches?
It can help headaches that start in the upper neck joints (cervicogenic headaches) when the test blocks relieve them. It is not a treatment for migraine itself.
When can I go back to work after neck RFA?
Most people return to desk work in a day or two. Avoid heavy lifting and hard workouts for a few days, as your physician advises.
Where can I get neck radiofrequency ablation near me?
Precision Care Medical & Sports Performance evaluates neck pain and plans neck radiofrequency ablation at all three offices:
- Brooklyn2781 Shell Rd, Suite 101, Brooklyn, NY 11223(718) 648-1234 · Get directions
- Staten Island1630 Richmond Rd, Suite 101, Staten Island, NY 10304(718) 339-7100 · Get directions
- Midtown Manhattan150 E 55th St, Suite 401, New York, NY 10022(212) 840-0135 · Get directions
Physical therapy for the neck is offered at the Brooklyn and Staten Island offices only.
Educational only, not medical advice. These videos and this article explain common problems and treatments in general terms. They are not a diagnosis or a treatment plan for you. Results vary from person to person. See a qualified clinician about your own symptoms, and call 911 or go to an emergency room for an emergency.
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