Cervical Radiofrequency (RF) Neurotomy Pain Treatment


The zygapophysial joints (“z-joints”) are small joints between the bones that make up part of the cervical spine or neck. These “z- joints” may become a cause of chronic neck pain. Cervical RF neurotomy can be performed to provide prolonged temporary pain relief if a diagnosis of “z-joint” pain has been made with two separate medial branch blocks. The procedure uses RF energy that results in heat generation causing a disruption of the pain signal from the nerves that supply the “z-joints” and thereby relieving the pain from the “z-joints”.


The procedure requires use of x-ray to precisely place the needle. Therefore, if you are pregnant, please inform your physician prior to the procedure. The amount of x-ray exposure is within recommended safe limits for adults, but can be hazardous to the developing fetus.

If you are on blood thinners or anticoagulants, please notify your physician. Special precautions or medication adjustments may be deemed necessary. However, do not stop your medication without consulting with your physician.

If you are a diabetic and take medications, notify your physician as medication adjustments may be necessary.

You will require a driver after the procedure, as it may be unsafe to operate a vehicle.

Notify your physician of any allergies you may have.

Before the procedure:

Take your medications as prescribed unless otherwise instructed by your physician. The procedure can be done in a physician’s office, ambulatory surgery center or hospital- based short procedure unit. You may have an intravenous line placed prior to the procedure. You may be given light sedation for comfort during the procedure.

During the procedure:

You will be placed onto a special table for the procedure. After cleansing the skin, drapes will be applied to ensure sterility. After numbing the skin and muscles of the neck, a special RF needle will be directed to the target nerve using x-ray guidance. After the RF needles are placed, a small amount of electrical current is passed through the needle to assure a safe distance from other nerves. Once the RF needles are accurately placed, heat is generated at the end of the needles that will create a lesion of the targeted nerve. You may feel some initial discomfort when the heating begins, though it should quickly subside. After the first lesion is completed, the RF needles will be moved slightly and additional lesions performed. This repeated lesioning improves the likelihood of a successful procedure and more prolonged duration of relief.

After the procedure:

Your skin will be cleansed and a bandage applied as necessary. You will be taken to a post-operative area and monitored for any adverse reactions, which are very rare. Keep in mind, the greatest benefit following RF neurotomy will often not be experienced until 4-6 weeks after the procedure. You may feel unsteady and should focus on horizontal objects such as window sills or floor edges.

Side effects or complications:

Side effects are generally minimal and can include increased discomfort, local bruising, headache, nausea, fainting or dizziness. These symptoms are usually short-lived and will resolve themselves. More severe complications are rare such as infection, allergic reaction, or nerve injury.

If you have any questions or concerns, please contact us at (610) 954-9400.