Radiofrequency medial branch denervation, also known as radiofrequency ablation (RFA) and rhizolysis, is a minimally invasive procedure used to treat persistent back or neck pain arising from the facet joints. It involves using heat energy to interrupt the small nerves (medial branches) that carry pain signals from these joints.
Facet joints are small stabilising joints located at each level of the spine. They can become inflamed or arthritic, leading to localised or referred pain. The medial branch nerves supply sensation to these joints.
RFA works by applying a precisely controlled electrical current through a special needle placed near the medial branch nerves. This current generates heat that temporarily disrupts the nerveâs ability to transmit pain signals. The procedure is done under X-ray (fluoroscopic) guidance to ensure accuracy.
Before proceeding with RFA, patients typically undergo diagnostic medial branch nerve blocks. If these blocks provide significant temporary relief, it confirms that the facet joints are the source of pain and that RFA is likely to be helpful.
Pain relief typically develops over 1â3 weeks. It is difficult to say exactly how long benefit may be from this procedure. Many do not need a repeat procedure due to ongoing benefit. .
RFA is carried out as an outpatient procedure, usually lasting 30â45 minutes. You will lie comfortably while the area is numbed with local anaesthetic. A thin needle is placed under X-ray guidance next to the medial branch nerve. The nerve is stimulated briefly to confirm accuracy before the radiofrequency energy is applied.
Sedation is usually offered. You can usually return home the same day and resume light activity within a few days.
All procedures carry some risks, which will be discussed in detail with you during your consultation. You will have the opportunity to ask questions, and formal consent will always be obtained before any procedure is carried out.
At Wessex Pain Clinic we find that the best results come from combining medical treatments with active rehabilitation. Procedures are often most effective when paired with physiotherapy, movement-based exercise, and â where appropriate â psychological support. This comprehensive approach addresses both the physical and emotional aspects of pain and supports longer-term improvement.
Results vary between individuals and cannot be guaranteed. Your consultant will discuss whether this procedure is appropriate for you.
At Wessex Pain Clinic, we work as a team and meet regularly to discuss complex, treatment resistant or unusual cases. As such you will often receive the expertise of several pain consultants. We believe that we are one of very few pain clinics to offer this.
Driving advice: You should not drive that day if receiving any sedation. Our procedures do vary on whether they are possible to drive home from yourself, please seek advice from your consultant about driving advice. If you are seeing us for an injection and planning on driving, please check with us beforehand about whether it will be possible to drive yourself home afterwards. Wessex Pain Clinic provides consultant-led assessment and treatment for acute and chronic pain conditions. Our multidisciplinary team includes Consultant Pain Specialists, Physiotherapists and Psychologists, offering evidence-based interventions alongside rehabilitation and self-management support. We welcome patients from across Hampshire, Dorset, Wiltshire, Surrey and Sussex, including Winchester, Basingstoke, Southampton, Portsmouth, and Chichester â with both in-clinic appointments and remote consultations available across the wider Wessex region.
Our friendly team is on hand to support you every step of the way. Please get in touch at any time.
