Neck Pain

How do we diagnose neck joint pain?

X-rays are often insufficient for identifying the source of pain, so the ideal method to determine if the neck joints are the source of pain is by anesthetizing these joints with a small amount of local anesthetic and observing if pain improves afterward.

How do we anesthetize the neck joints?

The first step is to identify the source of pain by anesthetizing the neck joints with a local anesthetic. In our intervention room, we assist you in lying on your side on the operating table. We then disinfect the neck area and, under fluoroscopic guidance, insert small needles into the side of the neck and direct them to the nerves around the joints in the spine. Once the needle position is confirmed accurately, we inject a small amount of local anesthetic, then remove the needles.

After the procedure, you can leave, and we will provide you with a form to track the pain level and any improvement during the next 6 hours. If there is a 50% or greater improvement in pain, we proceed with the next step, which is a radiofrequency ablation procedure.

How do we perform radiofrequency ablation?

Once we confirm that pain has improved with the local anesthetic, we move on to perform the radiofrequency ablation, which is done under fluoroscopy in our clinic. We assist you in lying on your stomach on the operating table. We disinfect the neck area and locally anesthetize the skin. Then, under fluoroscopy, we direct special needles that can be heated using a radiofrequency device. Once the needle’s position is confirmed accurately, we heat the needle tips to 80°C for 90 seconds using the radiofrequency device to ablate the nerves after they are locally anesthetized. This procedure takes about 20 minutes. Afterward, the nurse will provide you with post-procedure instructions, and then you can leave.

What can you expect after the procedure?

After the procedure, you may experience some neck pain for a day or more, but you can return to your daily activities right away. There is a small percentage of patients who may experience numbness or heightened sensitivity in the skin for up to 6 weeks post-procedure.

What are the chances of pain improvement after radiofrequency ablation? Is the improvement permanent?

Many studies show that about 70% of patients who improved with the initial local anesthetic also experience a good improvement in pain after the radiofrequency ablation. This means there is about a 30% chance that the pain may not improve after radiofrequency ablation, even if it improved with the initial anesthetic, because the source of the pain may not have been the joints. Instead, there may be another source of pain.

Improvement may last anywhere from 6 to 15 months, but it is not permanent. The pain may return after approximately a year due to the regrowth of these nerves, and thus, re-treatment with radiofrequency ablation may be required.

Are there any risks with radiofrequency ablation?

Like any medical procedure or medication, there are risks involved. However, we use the safest methods in all our procedures, and the likelihood of complications from radiofrequency ablation is very small. Potential risks include bleeding, bruising in the neck area, allergic reactions to the medications used, nerve damage, or lack of improvement after the procedure. For pregnant women, there is a risk to the fetus from the use of radiation, so we postpone the procedure until after childbirth. If you are taking blood-thinning medications, we will stop these medications before the procedure to reduce the risk of bleeding.