Cervical Facet arthropathy causing neck pain


Cervical facet blocks are given to diagnose and relieve pain due to cervical facet arthropathy or arthritis. During a cervical block, the doctor injects a pain-relieving fluid into the nerves that serve the neck. A combination of a local anesthetic and cortisone are usually used in the injection. The doctor uses X-ray guidance to place the injection in the correct nerve. If the procedure relieves the pain, the doctor knows that nerve is the source of the pain and the target for treatment. In some cases, the cervical block is all that is needed. In other cases, its effects wear off. If a cervical block successfully numbed the pain, it is likely that a patient will have a good response to radiofrequency ablation. If it does not, the patient probably is not a good candidate for radiofrequency ablation.

Cervical medial branch of DRG radiofrequency ablation uses heat generated by radiofreuency machine to ablate the target nerve. When the procedure is done on nerve tissue, it can provide relief from pain that hasn't been helped by other approaches. Radiofrequency ablation gives longer term pain relieve than nerve blocks or other types of injections.

Before the radio frequency ablation ( RFA) procedure an intravenous (IV) line will be started before the procedure begins. It will be used to give the patient drugs to make the procedure more comfortable and to calm fears. The area will be carefully cleaned and numbed before the IV line is inserted. During the procedure, the patient needs to be alert to help the doctor to correctly place the electrode used during the ablation procedure. The doctor will use X-rays to guide twin, insulated needles to the proper place next to the nerve. A tiny electrode is placed inside the needle. A small radiofrequency current is directed to the medial branch nerve of the joint capsule for 60 to 90 seconds. The radiofrequency waves make heat. This destroys the nerve tissue that is sending the pain signals to the brain. The procedure is done with sterile technique to minimize the risk of infection.After the procedure, you will be taken to a recovery area. The nurses will monitor you and be sure you do not have an allergic reaction. You will be allowed to leave once you are stable.

Special Instructions

Minimum of six hours of fasting is required before the procedure but clear instructions will be given to you with regards to this before your admission. You will be offered a drink after the procedure when you have come back to the ward from recovery. Take your usual medication and bring your medications with you. Patients taking warfarin/ Clopidogrel/ Aspirin will be given individual information as these medications need to be stopped few days before procedure. You should rest for about 24 hours. During that time you should not drive a car. You may feel more pain for several days after the procedure. Your doctor may give you additional pain relieving medications until this goes away. There may be some swelling or bruising where the needle was inserted. A cold pack will help reduce the swelling.

How much pain is relieved after the procedure varies from person to person. It can take three or more weeks for the full effects of radiofrequency ablation to be felt. The pain relief may last six months to a year or even longer. Sometimes, nerves do grow back. In such cases, the radiofrequency ablation may need to be repeated.

Side Effects And Complications

While this procedure is a safe, non-surgical treatment with low risks for complications. They sometimes do happen. Complications from radiofrequency ablation can include infections, numbness or allergic reactions to the medications or contrast dye that may be used during the procedure.