What is radiofrequency ablation (neurotomy)?

  • Radiofrequency ablation (RFA) uses a low-level electric current to heat up a small area of a nerve to stop it from sending pain signals. It can provide prolonged pain relief (up to 6-12 months) for certain pain conditions such as facet joint pain in the lower back and neck, commonly due to arthritis. The pain may eventually come back as nerves regrow, but this procedure can be repeated.

How is it done?

  • Before you have radiofrequency ablation (RFA), you will usually undergo a diagnostic injection or nerve block.
  • If a diagnostic injection gives you short-term pain relief (a few hours or days), you may be a candidate for ablation.
  • Your provider will use x-ray to perform the procedure.
  • Your provider will insert a small needle into the painful area. He or she will then send a small electrical current through the needle to make sure needle placement is correct and safe. Finally, after injecting local anesthetic to numb the area, your provider will use heat to lesion a small area of the nerve.
  • You will remain awake and aware during the procedure.


  • You can eat a light breakfast and drink fluids prior to your procedure
  • You may be asked to stop taking certain medications
  • Please advise your provider if you are taking antibiotics


  • Most people can walk around immediately after. You will be monitored for a period of time, and depending on the injection site, you may need a ride home.
  • You may resume full activity the next day.
  • Mild bruising and soreness around the injection site may occur. Applying ice for a few days may reduce inflammation and pain.
  • Recording pain levels for a few days or weeks may help to track the level of relief achieved.


  • Potential risks with local anesthetic (numbing) medications include numbness in the area and allergic reaction (rare).
  • Potential risks with inserting a needle include bleeding, infection, pain flare, allergic reaction, headache, and nerve damage (rare). 
  • Please notify the provider if the injection site becomes infected (fever or drainage at the injection site) or inflamed (redness, swelling, pain at the site), or if you suspect nerve injury.