Radiofrequency Treatment for Cervical Osteoarthritis (Cervical Facet Joint Denervation)

Transcript translated from Turkish (video audio remains in Turkish)

Facet denervation for facet joint disease, colloquially known as cervical osteoarthritis, is performed under imaging guidance and local anaesthesia. The medial branches are reached using fluoroscopy. A medial branch is a nerve that carries pain signals from the facet joints and lets us feel that pain.

Radiofrequency electrodes are then inserted. A computer-controlled device connected to the electrodes applies controlled heat to these nerves. The aim is to interrupt their nerve conduction and thus the transmission of pain.

The procedure takes 25 to 30 minutes.

What Is Cervical Radiofrequency Treatment?

Cervical radiofrequency treatment (cervical facet joint denervation) is an interventional treatment that reduces pain transmission by applying controlled heat to medial branch nerves in patients whose pain comes from a facet joint.

How Does Cervical Radiofrequency Treatment Work?

Radiofrequency applies heat to the medial branch nerve that carries pain signals from a facet joint, reducing transmission of those signals.

• Controlled Heat Technology: A device producing radio waves applies controlled heat to the nerve fibre, aiming to reduce transmission through the medial branch. Motor nerves supplying the arms are identified and protected using stimulation testing during the procedure.

Who Can Receive Cervical Radiofrequency Treatment?

It is used for patients whose pain originates in a facet joint. This algology procedure (interventional pain treatment) forms part of cervical osteoarthritis treatment for chronic facet-related neck pain; if needed, it can be performed in the same session as an epidural injection. Radiofrequency denervation does not eliminate spinal stenosis or compression of the spinal cord or nerve roots. When pain radiates into the arm and nerve root compression is suspected, treatment follows the approach for cervical spinal stenosis.

How Is Cervical Radiofrequency Treatment Performed?

It is performed in an operating theatre under local anaesthesia and fluoroscopic (live X-ray) guidance in 20–25 minutes.

• Imaging Guidance: The procedure is performed in an operating theatre, and a thin cannula is guided to the targeted nerve fibre under live X-ray imaging.
• Local Anaesthesia and Short Duration: No extensive preparation is needed; the procedure is performed under local anaesthesia and takes 20–25 minutes in most patients.
• Rapid Discharge: Patients walk home after a brief observation period. Avoiding heavy physical activity and sudden neck strain for the first 24–48 hours is sufficient.

Does Cervical Radiofrequency Denervation Relieve Chronic Neck Pain? (Success Rates)

Yes: in 61–74% of appropriately selected patients, pain disappeared completely or decreased substantially for at least six months, and patients returned to work [2]. For appropriately selected patients with facet-related pain, radiofrequency denervation markedly reduces neck pain; in a sham-controlled study, pain took about nine months (263 days) to return to half its original level after radiofrequency, versus eight days after the sham procedure [1]. Repeating treatment when pain returns can restore relief [3]. In patients diagnosed by clinical examination, the effect may not be apparent in the first months but emerges over the longer term [6]; some patients have another procedure within 6–12 months [4]. Appropriate patient selection has the greatest influence on the outcome [5].

What Are the Risks and Side Effects of Cervical Radiofrequency Treatment?

Risk is low; serious complications are rare, and studies reported no permanent nerve injury or weakness [1, 4]. Motor nerves supplying the arms are identified and protected by stimulation testing. The most common side effect is temporary numbness in the skin area supplied by the treated nerves; patients in the study did not find it troublesome [1]. Temporary skin sensitivity (local neuritis) or muscle pain lasting 1–2 weeks may also occur and resolve on their own. Infection and bleeding are uncommon; sterile technique and imaging guidance reduce these risks.

🩺 Physician’s Insight & Clinical Experience

“The mistake I most often see in my patients with cervical osteoarthritis is trying not to move their neck at all because of pain; muscles weaken in an inactive neck, and pain and restricted movement reinforce each other. My aim with radiofrequency is not to destroy the joint itself, but to silence the pain alarm travelling from it to the brain. When I target the nerve precisely under imaging and deliver the radiofrequency current, the patient’s pain decreases substantially. Once pain is relieved, the patient starts moving their neck comfortably and doing their exercises; that is the real benefit.”

Frequently Asked Questions

What Is Cervical Radiofrequency Treatment and How Is It Performed?

It reduces pain transmission by applying controlled heat under fluoroscopic guidance to the medial branch nerves carrying pain signals from the facet joints. The procedure takes place under local anaesthesia and lasts 20–25 minutes.

What Is the Success Rate of Cervical Radiofrequency Treatment?

In approximately two-thirds of appropriately selected patients, pain disappears completely or decreases substantially for at least 6 months [2]; the procedure can be repeated when pain returns [3].

Does Cervical Radiofrequency Treatment Have Risks or Side Effects?

Yes, but serious complications are rare. The most common effects are temporary numbness in the skin area supplied by the treated nerves and skin sensitivity at the treatment site that can last a few weeks; both resolve on their own [1]. Motor nerves supplying the arms are protected by stimulation testing.

Is There a Risk of Paralysis During Radiofrequency Facet Joint Denervation?

No, paralysis is not an expected complication of this procedure. Radiofrequency energy is applied only to the medial branch nerve transmitting pain from the joint; motor nerves supplying the arms are identified and protected by stimulation testing, and the procedure is performed in an operating theatre under live imaging. New weakness or widespread numbness after the procedure requires urgent medical assessment.

What Should I Do After Cervical Radiofrequency Treatment?

Prolonged rest is not needed; avoiding heavy physical activity and sudden strain on the neck for the first 24–48 hours is sufficient.

How Long Does Cervical Radiofrequency Treatment Last, and Can It Be Repeated?

In appropriately selected patients, relief lasts for months; the procedure can be repeated when pain returns [3].

Will I Be Asleep During Radiofrequency Treatment, and Is It Painful?

No, you will not be put to sleep. The procedure is performed under local anaesthesia; brief stinging or pressure may be felt when the cannula makes contact, but there is no unbearable pain.

How Many Minutes Does Cervical Radiofrequency Treatment Take?

The procedure takes 20–25 minutes.

How Long Must I Stay in Hospital Afterwards?

After a brief observation period, you can walk home the same day.

Which Specialist Performs Radiofrequency Treatment for Cervical Osteoarthritis in Istanbul?

One of the physicians performing radiofrequency treatment for cervical osteoarthritis in Istanbul is M. Levent Deniz, MD, a specialist in neurosurgery.

How Much Does Radiofrequency Treatment for Cervical Osteoarthritis Cost?

The cost depends on the number of facet joint levels treated, whether a combined injection is needed and hospital conditions; a definite fee can only be determined after examination and review of imaging.

References

1. Lord SM, Barnsley L, Wallis BJ, McDonald GJ, Bogduk N. Percutaneous radio-frequency neurotomy for chronic cervical zygapophyseal-joint pain. N Engl J Med. 1996;335(23):1721-1726. PMID: 8929263.
2. MacVicar J, Borowczyk JM, MacVicar AM, Loughnan BM, Bogduk N. Cervical medial branch radiofrequency neurotomy in New Zealand. Pain Med. 2012;13(5):647-654. PMID: 22458772.
3. McDonald GJ, Lord SM, Bogduk N. Long-term follow-up of patients treated with cervical radiofrequency neurotomy for chronic neck pain. Neurosurgery. 1999;45(1):61-67. PMID: 10414567.
4. The Efficacy and Safety of Radiofrequency Neurotomy in the Treatment of Chronic Cervical Facet (Zygapophyseal) Joint Pain: A Retrospective Study. J Turk Spinal Surg. 2024. DOI
5. Hurley RW, Adams MCB, Barad M, et al. Consensus practice guidelines on interventions for cervical spine (facet) joint pain from a multispecialty international working group. Pain Med. 2021;22(11):2443-2524. PMID: 34764220.
6. van Eerd M, de Meij N, Kessels AGH, et al. Efficacy and Long-term Effect of Radiofrequency Denervation in Patients with Clinically Diagnosed Cervical Facet Joint Pain: A Double-Blind Randomized Controlled Trial. Spine (Phila Pa 1976). 2021;46(5):285-293. PMID: 33534439.

• 👨‍⚕️ Author and medical reviewer of this content: M. Levent Deniz, MD – Neurosurgery Specialist
• ⚠️ Medical Disclaimer: This page is for information only; consult your doctor for diagnosis and treatment.