This minimally-invasive procedure, also called radiofrequency, reduces or eliminates the pain of damaged facet joints of the neck and shoulders by disrupting the medial branch nerves that carry pain signals.

X-ray guidance is used to carefully guide a needle-like tube (cannula) to the irritated medial branch nerves. Then, a radiofrequency electrode is inserted through the cannula, which heats and cauterizes the nerve. This disrupts its ability to communicate with the brain, blocking the pain signals.

All injections are performed under fluoroscopy (x-ray) guidance.

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What can you expect after the injection?

After the procedure is done on an outpatient basis you may experience some muscle and neck discomfort which goes away over several weeks. Your physician may have you do physical therapy during your recovery to help you regain your strength and get back to your activities.

Radiofrequency usually blocks the signal for a prolonged period of time. Eventually, the nerve grows back and can allow the pain signal to be transmitted again. If this happens the procedure can be repeated.

Treatment Algorithm

Prognostic Block #1

  • Local anesthetic is used to numb the nerves that go to the joints and to accurately determine the pain generator
  • Pain relief expected to last 4-6 hours
  • Patient is instructed to do activities that normally increase pain
  • Our office will call you the following day to record your degree of pain relief for the first 8 hours following the block
  • Adequate pain relief = move forward to the second block

Prognostic Block #2

  • Same as first block
  • Required by insurance
  • Office will call the following day to record your degree of pain relief for the first 8 hours following the block
  • Adequate pain relief = move forward to RFA

Lumbar RFA

  • Special needle gently guided to same area as the blocks
  • Motor and sensory testing conducted to ensure safe and accurate needle placement
  • Tip of the needle emits radiofrequency energy to heat the nerve and stop the conduction of pain signals to the brain

Healing Process

  • Possible increased pain for 2-4 weeks
  • Feeling of sunburn with possible redness of skin
  • Maximum pain relief may take a few weeks due to natural healing process
  • Assuming facet joints were the primary pain generator, relief expected to last approx. one year

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Dr. David Provenzano, a leading expert throughout the nation for treating patients who suffer daily from pain, uses advanced diagnostic techniques to assess the source of the pain and develop a comprehensive and safe treatment approach that can significantly reduce your pain.

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