Guide to Radiofrequency Treatment Chronic Back Pain And Neck Pain
This comprehensive guide explores radiofrequency treatment (RFA) for chronic back and neck pain, detailing its procedure, benefits, risks, and costs. Learn how RFA can significantly improve your quality of life by safely disrupting tiny pain-carrying nerves.
Written by Dr. Siri Nallapu
Reviewed by Dr. Shaik Abdul Kalam MD (Physician)
Last updated on 27th Oct, 2025
Introduction
Chronic back and neck pain can take over your life—limiting work, daily activities, sleep, and mood. If medications, physical therapy, and injections haven’t given you lasting relief, radiofrequency treatment (often called radiofrequency ablation or RFA) might be the next step your doctor suggests. This minimally invasive procedure uses heat from radiofrequency energy to safely disrupt tiny pain-carrying nerves in the spine. The goal is simple: reduce pain so you can move more and get back to living.
In this guide, you’ll learn how radiofrequency works, who it helps, what to expect during and after the procedure, success rates and risks, and how it compares with other options. We’ll also address costs and access, share practical recovery tips, and answer FAQs. Throughout, we’ll keep the focus on helping you make an informed, confident decision about radiofrequency treatment for chronic back pain and neck pain. If your pain has persisted beyond two weeks despite basic measures, consider consulting a doctor online with Apollo 24|7 for timely evaluation and next-step planning.
Consult a Top General Practitioner for Personalised Advice
What is Radiofrequency Treatment for Spinal Pain?
RFA is a minimally invasive technique that uses thermal energy to temporarily disrupt pain signals from spinal joints.
Radiofrequency treatment—often called radiofrequency ablation (RFA), radiofrequency denervation, or medial branch neurotomy—is a minimally invasive procedure to reduce chronic spinal pain, especially in the lower back (lumbar), mid-back (thoracic), and neck (cervical) regions. It targets small sensory nerve branches that carry pain signals from joints in your spine to your brain. By generating controlled heat at the nerve, RFA “turns down” the pain without affecting strength, balance, or the structure of your spine.
Terms You’ll Hear
- Radiofrequency ablation (RFA): Uses radio waves to create thermal energy that disrupts the pain nerve function.
- Denervation/neurotomy: Describes the result—interrupting nerve signalling from the painful joint.
- Medial branch ablation: Refers specifically to nerves that supply the facet joints.
Which Spinal Pain Generators Does It Target
- Facet joint pain: Often from arthritis/spondylosis; common in both the neck and low back.
- Sacroiliac (SI) joint pain: Pain where the spine meets the pelvis; specific lateral branch nerves can be treated.
- Less commonly, some specialised centres use RF techniques for discogenic pain or post-surgery pain, but these are more
selective use cases.
RFA is typically considered after conservative care (medications, physical therapy) and diagnostic injections suggest the
targeted joint is the main source of pain. When used appropriately, RFA can reduce pain and improve function for
months, sometimes longer. If your symptoms have not responded to first-line care, speak with a spine specialist; an
online consult via Apollo 24|7 can help you decide if RFA should be on your shortlist.
How Radiofrequency Ablation Works in Your Spine
RFA relies on precise, imaging-guided heat application to create a lesion on the pain-carrying nerve.
Facet joints are small joints at the back of each spinal segment. Tiny nerves called medial branches carry pain from
these joints to the spine. In the SI joint, lateral branches play a similar role. RFA uses a thin probe, guided by fluoroscopy (live X-ray) or CT, to reach these nerves. Sensory stimulation confirms you’re on the correct nerve; then heat (usually about for 60–90 seconds) creates a small lesion to interrupt pain signalling.
Heat, Lesion Size, and Precision Targeting
- Precision matters: The nerves are just millimetres wide, so proper needle placement and parallel orientation to the nerve
maximise success. - Lesion size: The size and shape of the heat lesion depend on temperature, time, and probe size. Larger lesions can
improve capture of the nerve, especially in neck procedures. - Durability: Nerves can regrow over months, which is why relief typically has a finite duration.
Conventional, Cooled, and Pulsed Radiofrequency
- Conventional RFA: Standard approach; strong evidence for facet joint pain when candidates are carefully selected.
- Cooled RFA: Uses internally cooled probes to create larger, spherical lesions; often used for SI joint pain with promising results.
- Pulsed RF (PRF): Uses lower temperatures (about $42^\circ\text{C}$) with pulsed energy; aims to modulate rather than ablate nerves. Evidence is mixed but may help in select cases where thermal ablation isn’t suitable.
Who Qualifies: Diagnoses, Tests, and Diagnostic Blocks
Successful RFA treatment is highly dependent on accurately confirming the source of pain using diagnostic nerve
blocks.
Facet, Sacroiliac, and Whiplash-Associated Pain Patterns
- Facet joint pain: Typically, aching pain worsened by extension (leaning back) and rotation, with tenderness over the joints. In the neck, may radiate to the shoulder or head (cervicogenic headache).
- SI joint pain: Buttock pain, sometimes radiating to the thigh; positive provocation tests on exam.
- Whiplash-associated disorders: Cervical facet pain is common after rear-end accidents.
Role of Medial Branch and Lateral Branch Blocks
Before RFA, most specialists perform diagnostic nerve blocks—injecting a tiny amount of local anaesthetic near the suspected pain-carrying nerve:
- Goal: If the block temporarily relieves your typical pain (often by 50–80% for the anaesthetic’s duration), it confirms the
joint-nerve pathway as the pain source and predicts RFA success. - Single vs double blocks: Some guidelines favour performing two blocks on different days to reduce false positives,
though this can delay care and increase cost. Your doctor will discuss the approach that fits your situation.
Why Sedation Can Affect Block Accuracy
Sedation during diagnostic blocks can relax muscles and alter pain perception, increasing the chance of a false positive.
Many experts recommend minimal or no sedation for accuracy during blocks and sensory testing. For the actual RFA,
light sedation is often okay.
Benefits You Can Expect: Relief, Function, and Success Rates
Most patients experience a significant drop in pain scores and improved physical function for 6–18 months.
What the Evidence Shows and How Long Relief Lasts
- Facet joint RFA: In carefully selected patients (with positive diagnostic medial branch blocks), 60–80% achieve
meaningful pain relief and improved function. Relief often lasts 6–12 months and sometimes 18 months or longer.
When pain returns, repeat RFA can be similarly effective. - Cervical (neck) RFA: Success rates are comparable or slightly higher than lumbar in some series, especially for
cervicogenic headache and post-whiplash facet pain. - SI joint RFA: Cooled RF for lateral branches shows benefit for many patients, although evidence is somewhat more variable than for facet joints.
Realistic Goals and Quality-of-Life Gains
- Pain reduction: Most patients report at least a 50% drop in pain scores.
- Function: Easier walking, standing, sitting, and sleeping; better participation in physical therapy.
- Medications: Many reduce reliance on daily pain medications, including opioids.
- Work and activities: Return-to-work rates improve when RFA is paired with rehab.
Risks, Side Effects, and How to Minimise Them
RFA is generally safe, but common short-term side effects include temporary pain, soreness, or numbness at the
injection site.
Common, Uncommon, and Rare Complications
- Common, short-term: Soreness or bruising at the entry site; temporary pain flare for a few days as the nerve settles; numbness or tingling near the treatment zone.
- Uncommon: Neuritis (irritated nerve causing zinging pain), transient dizziness after cervical RFA, and temporary
increased back or neck pain. - Rare: Infection, bleeding or haematoma, skin burn, damage to non-target nerves or blood vessels; allergic reaction to
medications.
Strategies to Reduce Risk Before and After RFA
- Before: Review all medications (especially blood thinners) with your clinician; manage diabetes for optimal wound
healing; arrange a ride home. - During: Choose a clinician using imaging guidance (fluoroscopy or CT), sensory/motor testing, and sterile technique.
- After: Ice for 10–15 minutes as needed; avoid strenuous activity for a few days; gently reintroduce movement; begin or resume a targeted physical therapy programme within 1–2 weeks.
The Day of Your Procedure: Step-by-Step
The procedure involves preparation, precise needle placement using imaging, nerve testing, and the heat application
itself.
Preparation, Imaging Guidance, and Sensory Testing
- Arrival: You’ll check in, sign consent, and review allergies and medications. An IV may be placed for light sedation,
though many procedures use local anaesthetic only. - Positioning and prep: You’ll lie on a procedure table. The skin is cleaned, and local anaesthetic is used to numb the
entry area. - Needle placement: Using fluoroscopy or CT, the doctor advances a thin probe to the target nerve(s).
Sensory/Motor Testing
A tiny electrical current may produce a familiar deep ache (sensory confirmation) without causing muscle twitch in areas that would indicate proximity to motor nerves.
What You’ll Feel and How Long It Takes
- Ablation: The tip heats for 60–90 seconds per lesion. You may feel warmth or pressure; additional local anaesthetic is
often used. - Duration: Most procedures take 30–90 minutes, depending on the number of levels treated.
- After: A brief recovery period ensures you’re stable and comfortable. You’ll go home the same day with instructions for
activity and pain control.
Recovery, Aftercare, and Making Relief Last
Successful long-term outcomes depend on a structured recovery that includes physical therapy to rebuild strength.
Activity Timeline and Flare Management
- Days 0–3: Expect mild soreness or a “sunburn-like” feeling. Use ice intermittently. Short walks are encouraged. Avoid
heavy lifting or twisting. - Days 4–14: Gradually increase daily activity. Gentle stretches and posture drills can start. Over-the-counter pain
relievers may be used as advised. - Weeks 2–6: Begin or resume guided physical therapy focused on core and hip strength (lumbar) or deep neck flexor
strength and scapular control (cervical). Many feel noticeable pain reduction by weeks 2–4.
Flare Plan
A short-lived pain flare can occur; have a plan with your clinician for topical therapy, short-course medications, and
pacing your activities.
Physical Therapy, Posture, and Strength Programmes
- For low back pain: Emphasise hip hinge mechanics, gluteal and deep core strengthening, and endurance walking.
- For neck pain: Train deep neck flexors, mid-back (scapular) strength, and ergonomic strategies for screens and reading.
- Sleep and recovery: Sleep quality affects pain perception. Optimise your sleep routine; consider checking vitamin D if
fatigue is prominent. - Lifestyle: Weight management, anti-inflammatory diet patterns, and stress reduction amplify gains from RFA.
RFA vs Other Options: Injections, Surgery, and Newer Tech
RFA typically provides longer pain relief compared to isolated steroid injections and is less invasive than surgery.
Steroid Injections, Epidurals, and Nerve Blocks
- Facet injections: Deliver a steroid to the joint; may calm an acute flare but typically short-lived compared with RFA.
- Medial branch blocks: Diagnostic tool more than long-term treatment; relief is temporary by design.
- Epidural steroid injections: Better for radicular (nerve root) pain than for facet pain.
Surgery, Spinal Cord Stimulation, and PRF/Cooled RFA
- Surgery: Generally not indicated for isolated facet or SI joint pain without instability or nerve compression. RFA is far
less invasive and often preferred first. - Spinal cord stimulation (SCS): For widespread neuropathic or postsurgical pain unresponsive to other care; a different
mechanism than RFA. - Pulsed RF: Non-destructive, may help in selected cases where nerve ablation is undesirable (e.g., close to motor nerves).
- Cooled RF: Particularly useful for SI joint lateral branches due to broader lesion size.
Cost, Access, and Choosing the Right Specialist
Confirming insurance coverage and choosing an experienced specialist are key steps before undergoing RFA.
Typical Costs (India and Global) and Insurance
- India: Depending on the city, hospital, and number of levels treated, radiofrequency ablation typically ranges from
about ₹20,000 to ₹70,000 per session. Insurance may cover RFA when criteria are met (evidence of facet/SI pain,
failed conservative care, positive diagnostic blocks). - Global estimates: In the US and UK, RFA costs are higher, often billed per level/side; many insurers require
documented relief from diagnostic blocks before approving treatment.
Questions to Ask Your Doctor
- How confident are you in the diagnosis of facet or SI joint pain for my case?
- What was the response to my diagnostic block(s)?
- How many RFAs do you perform monthly, and what is your typical success rate?
- Will you use fluoroscopy or CT guidance and sensory/motor testing?
- What is your plan for rehab after RFA?
- If relief fades, what is the plan for repeat radiofrequency ablation?
When to Seek Medical Help and Red Flags
Chronic pain lasting over two weeks needs professional evaluation, and certain severe symptoms require urgent medical
care.
Timeline for Self-Care vs Professional Care
- Try self-care initially: Brief rest, gentle movement, heat/ice, and over-the-counter pain relievers (as appropriate).
- Seek care if: Pain persists beyond 2–6 weeks, interferes with work/sleep, or returns after every conservative trial. If
symptoms persist beyond two weeks, consult a doctor online with Apollo 24|7 for further evaluation.
Red Flags: Seek Urgent Care
- New or worsening limb weakness, numbness in a saddle distribution (groin, inner thighs), difficulty controlling bladder or bowels, fever with severe back pain, unexplained weight loss, or a history of cancer with new severe pain. Book a
physical visit to a doctor with Apollo 24|7 if any red flags are present.
Conclusion
Radiofrequency treatment can be a turning point for people living with chronic back and neck pain—especially when
the pain originates in the facet or sacroiliac joints. The procedure is minimally invasive, typically done as day-care, and supported by evidence showing meaningful pain relief and better function for many appropriately selected patients. The keys to success are accurate diagnosis with diagnostic blocks, skilled technique with imaging and sensory testing, and a proactive recovery plan that includes physical therapy and gradual return to activity.
If you’ve struggled with pain despite medications, exercises, and injections, RFA may allow you to move more, sleep
better, and do more of what you love. Talk with a spine or pain specialist about whether you’re a candidate. If you need timely guidance, consult a doctor online with Apollo 24|7 to review your symptoms and imaging, discuss diagnostic blocks, and plan next steps. With the right strategy and support, radiofrequency ablation can be a safe, effective part of your long-term pain management plan.
Consult a Top General Practitioner for Personalised Advice
Consult a Top General Practitioner for Personalised Advice
Dr. Syed Ismail Ali
General Practitioner
7 Years • MBBS
Hyderabad
Apollo 24|7 Clinic, Hyderabad
Dr. Anand Ravi
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr Syed Mateen Pasha
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. Johnson. S
General Practitioner
7 Years • MBBS MD(Preventive and social Medicine)
Pune
Apollo Clinic, Nigdi, Pune
Dr. Madhuri Sai Sreepada
General Practitioner
9 Years • MBBS
Hyderabad
BRIGHT SMILES MEDICARE & DENTAL CARE, Hyderabad
Consult a Top General Practitioner for Personalised Advice
Dr. Syed Ismail Ali
General Practitioner
7 Years • MBBS
Hyderabad
Apollo 24|7 Clinic, Hyderabad
Dr. Anand Ravi
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr Syed Mateen Pasha
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. Johnson. S
General Practitioner
7 Years • MBBS MD(Preventive and social Medicine)
Pune
Apollo Clinic, Nigdi, Pune
Dr. Madhuri Sai Sreepada
General Practitioner
9 Years • MBBS
Hyderabad
BRIGHT SMILES MEDICARE & DENTAL CARE, Hyderabad
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Frequently Asked Questions
1. How long does radiofrequency ablation last for back pain?
Relief commonly lasts 6–12 months and sometimes up to 18 months. If pain returns as the nerve regrows, a repeat radiofrequency ablation can provide similar benefit for many patients.
2. Is radiofrequency ablation safe for neck pain?
Yes. Cervical RFA is considered safe when performed by experienced clinicians using imaging guidance and sensory/motor testing. Temporary soreness or a brief pain flare is common; serious complications are rare.
3. What is the recovery time after RFA?
Most people return to light activity within 24–72 hours and to normal routines in about a week. Significant pain relief often emerges within 2–4 weeks, especially when combined with physical therapy.
4. Will radiofrequency ablation help sciatica?
RFA is best for facet or sacroiliac joint pain. Sciatica is usually caused by nerve root compression (e.g., a disc herniation); treatments such as epidural steroid injections or surgery may be more appropriate. Your doctor can help distinguish the pain source.
5. What does radiofrequency ablation cost in India?
Costs commonly range from ₹20,000–₹70,000 per session, depending on the city, hospital, and levels treated. Insurance may cover the procedure when diagnostic criteria are met. Confirm pre-authorisation and out-of-pocket expenses with your provider.