Facet Radiofrequency Thermocoagulation

This procedure is a day case and is usually quick and simple as it uses local anaesthetic. One radiofrequency injection only takes a few minutes, but the whole procedure can take up to 30 minutes. It may take up to 2 hours if you are having multiple radiofrequency injections.

1. Your consultant will do some basic health checks, such as blood pressure and pulse rate.

2. Your consultant will explain the procedure, answer any questions and ask you to sign a consent form.

3. Once you’re in your hospital gown and on the treatment couch, your consultant will clean the site where the radiofrequency probe needle will be inserted.

4. You’ll have local anaesthetic injected so that the area is numbed to any pain from the needle. You may feel a sting for a few seconds before it goes numb.

5.  Your consultant will guide the radiofrequency needle to the facet joints in the affected area using imaging equipment (such as an X-ray or CT scan) to help them find the correct spot.

6. Your consultant will electrically stimulate your nerves with the radiofrequency needle and check to see if you’re experiencing tingling, muscle twitch or discomfort. This is to confirm the right nerves are being targeted.

7.   Once the correct nerves are identified, the nerves are deactivated using radiofrequency heat.

8.    If you’re having a combined treatment with facet joint injections, this will deliver local anaesthetic and steroids to the chosen facet joints.

9. You may need more than 1 radiofrequency injection depending on how many joints need to be treated.

10. Your consultant will cover the site of the injections with a small dressing.

Your consultant will take every necessary precaution to reduce the very low risk of complications and will discuss these with you. The most common is some form of tenderness around the injection site, which may last for up to 3 weeks.

Common after-effects include:

• bruising or tenderness at the injection site

• occasionally, mild skin irritation or superficial burns can occur around the injection site

• temporary numbness around the needle site

• temporary numbness or a burning sensation in your buttocks and legs or your shoulder and neck that usually goes away after 2 to 3 hours

• increased pain, stiffness or soreness for a few days to 2 weeks  

Rare complications:

• infection that might need antibiotic treatment

• bleeding

• your usual pain becoming worse

• nerve damage

Before the procedure, we’ll make sure you feel as comfortable as possible and give you the information you need.

Your consultant will tell you which medicines you should either stop taking, or take, in the days leading up to your facet radiofrequency thermocoagulation. For example:

• if you are on any blood-thinning medication such as aspirin, clopidogrel, warfarin, rivaroxaban, apixaban, or dabigatran, your consultant may adjust your dose

Tell your consultant as soon as possible if:

• you have any allergies

• you have an infection

• there’s any chance you could be pregnant

On the day, you can usually eat and drink as normal, and take your medications as agreed with your consultant.

You’ll spend some time in a recovery room to allow your consultant to monitor you for any side effects, such as feeling sick, numbness, or problems controlling your bladder or bowel. Once you are ready to leave – usually within half an hour to a few hours – you can go home.

  Some key things to note on the first day:

1. Have someone with you to get you home – you may experience some numbness or weakness in your back.

2. Don’t drive or use public transport to get home.

3. Rest for the remainder of the day.

4. For 24 hours after the treatment, don’t drive, drink alcohol, operate machinery, sign legal documents, or provide childcare on your own.

In the following days and weeks, be aware of these things:

1. It’s normal to feel an increase in the level of your pain for a few days – you can continue to take your normal pain medication, or call your consultant for guidance if you need more pain relief.

2. You can usually drive safely within 2 to 3 days, but be aware that painkillers can affect your levels of drowsiness, and you just make a safe judgment.

3. Avoid bending and lifting for 1 to 2 weeks.

4. Carry on with your normal activities.

5.  Do any physiotherapy exercises recommended by your consultant.

6. Reduce your painkillers and gently increase your activity levels if the pain relief from the treatment starts to appear.

7. Tell your consultant about any signs of infection, such as warmth, redness or tenderness at the injection sites, or if you feel hot and unwell.

8. Tell your consultant if you notice increasing pain or numbness that isn’t going away.

Our consultants will always want to have a follow-up consultation to provide the best personalised pain management for you. This will be to discuss:

• how well the treatment worked for you

• future pain management approaches based on your results, such as additional physiotherapy or a change of pain medication options

Please contact our Pain Medicine centre for pricing information.

At Welbeck, our pain specialists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

To book facet radiofrequency thermocoagulation treatment, you must be referred by either your GP or a specialist managing your particular pain condition following a consultation with them. Self-referrals are not accepted for this treatment.

If you would like to schedule a consultation with a Pain Medicine centre consultant, please get in touch to make an appointment. Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.