Why Am I Being Offered this Procedure?

Your doctor suspects that neck, head, shoulder, or scapula pain may be caused by irritation of the cervical facet joints.
These small joints connect the vertebrae of the neck and allow head and neck movements.
When they are damaged or inflamed, they can cause chronic pain.

If previous diagnostic tests (injections with local anesthetic) have reduced your pain, radiofrequency denervation can be proposed as a more lasting treatment.

What are joint facets?

The facet joints are the contact surfaces between two adjacent vertebrae.
They are innervated by small nerves called medial articular branches, which transmit pain signals to the brain.

What is Cervical Facet Joint Denervation?

It is a targeted procedure for treating chronic pain originating from the facet joints.
Using a special needle, controlled heat (approximately 80°C) is applied to the nerves that transmit pain.
This interrupts the pain signals and can lead to lasting relief.

Before the Procedure: What to Know

Inform your pain specialist if:

• You have a fever or feel unwell
• You have allergies to medications, local anesthetics, or contrast agents
• You are taking anticoagulant medications (they may need to be suspended)
• You are pregnant (the procedure uses X-rays and will be postponed)

Preparation:

• Fasting for at least 6 hours before the procedure.
• Arrange for a companion: you will not be able to drive after the treatment.

How is the Procedure Performed?

• The denervation technique is performed as described by Koetsier et al., Pain Research and Management, 2024 (PubMed ID: 37535782).
• An intravenous access will be placed for safety.
• You will lie face down on an examination table.
• The skin will be disinfected and locally anesthetized.
• Under radiological guidance, the doctor will position a needle near the nerve.
• The position will be confirmed with small test stimulations.
• Then the tip of the needle will be heated to about 80°C for each nerve.
• After a short observation period, you can return home with a companion.

Duration of the procedure: about 30 minutes.
After an observation period of about 30 minutes, you can go home accompanied.

What Happens Afterwards?

• You may experience a slight increase in pain in the first 2–3 days, up to 2–3 weeks, due to the inflammatory reaction.
• These discomforts usually improve spontaneously or with regular painkillers within about 14 days.
• On average, about 75% of patients report pain improvement similar to that obtained with the diagnostic block.

You will be given a form to fill out to monitor the progress of the pain after the treatment.

How Long Do the Benefits Last?

• The pain may return after 6-14 months, due to the natural regeneration of the nerves.
• If necessary, the procedure can be repeated after a new diagnostic evaluation.

Are there Risks or Side Effects?

The procedure is generally safe. Possible side effects include:

• Pain or discomfort in the treated area in the following days
• Rarely infections, bleeding, or nerve injuries (damage to a nerve)

Serious complications are very rare.

Remember:

• Do not drive for 24 hours after the procedure.
• Arrange for a companion for the return home.
• Carefully fill out the form that will be given to you and return it to your pain doctor.