Cervical Medial Branch Radiofrequency Ablation
If you have been living with chronic neck or shoulder pain that has not responded to conventional treatment, Radiofrequency Ablation (RFA) is an advanced interventional procedure that provides long-lasting pain relief. It works by using precisely targeted heat generated from high-frequency radio waves to deactivate the small nerve branches that transmit pain signals from the cervical facet joints to the brain.
Understanding the Two Types of Neck Pain
Before recommending RFA, the physician will carefully assess the nature of your pain to ensure this is the right treatment for your specific condition.
- Localised neck pain — pain confined to the neck itself, or referring into the shoulder blade, without travelling down the arm. This type typically originates from degeneration or inflammation of the cervical facet joints and responds best to RFA treatment.
- Radicular neck pain — pain, tingling, or numbness that radiates down the arm along a nerve pathway. This pattern suggests compression of a major nerve root rather than facet joint pathology, and is generally better managed with an epidural steroid injection (ESI) rather than RFA.
Accurate diagnosis of which type you have is essential — RFA is highly effective for facet-mediated pain but is not the appropriate treatment for radicular pain.
Who Is This Procedure Suitable For?
- Chronic neck or shoulder pain confirmed to originate from cervical facet joint degeneration
- A positive response to a cervical medial branch block — a diagnostic injection that temporarily numbs the target nerve branch; significant pain relief following this test confirms that the pain is facet-mediated and that RFA is likely to be effective.
- A desire to reduce ongoing dependence on pain medication and achieve more sustained, durable relief
The Procedure
The procedure is safe, precise, and typically takes 45–60 minutes depending on the number of nerves being treated.
- Positioning — the patient lies on their side in a comfortable, relaxed position. A mild sedative may be administered if clinically appropriate
- Image guidance — the physician uses real-time ultrasound and/or fluoroscopy (X-ray guidance) to accurately locate the medial branch nerve at each cervical level, ensuring precise and safe needle placement
- Ablation — a radiofrequency needle is advanced to the target nerve position; controlled heat is then delivered to deactivate the nerve fibres responsible for transmitting pain signals, without affecting the adjacent motor nerves that control neck movement
Expected Outcomes
- Long-lasting pain relief — most patients experience sustained reduction in pain for 3–6 months, with some achieving relief beyond 12 months
- Improved quality of life and neck mobility — as pain decreases, patients can move their neck more freely and reduce or eliminate the need for daily pain medication
- Temporary skin numbness — some patients notice a mild patch of reduced skin sensation over the neck and shoulder following the procedure; this is a normal, expected short-term effect of the nerve deactivation and typically resolves on its own
Post-Procedure Care and Recovery
- Travel safety : Do not drive on the day of the procedure.
- Rest : Rest adequately for the first 24 hours. Avoid activities that strain the neck — such as heavy lifting, prolonged looking down, or any movement that causes neck tension.
- Injection site : Mild soreness or stiffness at the needle sites is normal and typically resolves within 1–2 days. This should not be confused with a return of the original pain.
Pain Management at Bangkok Interventional Clinic
At Bangkok Interventional Clinic, we focus on personalised, in-depth pain management tailored to each individual.
- All patients are evaluated and treated by a board-certified pain specialist, ensuring accuracy, safety, and effective care.
- Targeted interventional procedures for fast and effective symptom relief
- Patient education to support sustainable, long-term self-care
Our goal is to meaningfully improve the quality of life of every patient we treat. If you are living with pain that affects your daily life, the right diagnosis and the right treatment plan are where change begins.
