People of a certain age know the feeling. You’re pulling your car onto a busy street, craning your neck to see if it’s safe to proceed. But your neck is kind of creaky and, to compensate for the pain and stiffness, you have to pivot your entire body in the seat so that you can get a clear view of oncoming traffic.
“People with cervical spondylosis or other types of arthritic conditions of the neck or back encounter numerous difficulties in their daily living,” says Jose Mena, M.D., a board-certified physiatrist at Miami Orthopedics & Sports Medicine Institute, a part of Baptist Health South Florida. “Whether it’s driving, working, sleeping or even just brushing your teeth, the pain can be quite limiting.”
Dr. Mena has had success treating patients with a simple outpatient procedure – cervical thermal radiofrequency neurotomy – that uses a small burst of energy to permanently block, or denervate, those nerve endings causing the pain. The x-ray-guided procedure, performed under local anesthesia, involves placing two needles in the patient’s cervical or lumbar spine at the precise spot where the nerves are that supply the painful joint. A small, painless burst of energy disables just those nerve endings so that the patient no longer feels pain, yet experiences no loss of function to the joint.
“We’ve had extremely good outcomes with cervical thermal radiofrequency neurotomy,” says Dr. Mena, who also serves as the team pain physician for the Miami Dolphins. “Following the procedure, patients notice an immediate improvement in their range of motion, and after a couple of weeks their pain is completely gone.”
Dr. Mena adds that cervical thermal radiofrequency neurotomy is the treatment of last resort for many patients. “For it to be successful, there is no margin for error,” he says. “Prior to the actual treatment, we do two diagnostic procedures, about one week apart, which will tell us precisely where we need to place the needles when we do the denervation.”
The procedure itself takes roughly 30 minutes, according to Dr. Mena, and the patient feels no pain. A follow-up exam one year later ensures that the treatment’s effects have been sustained. “It takes about a year for nerves to completely regrow,” Dr. Mena says. “We can see at that point if the treatment needs to be repeated but for a select number of patients, no further treatment is required.”
The goal, says Dr. Mena, is to get the patient treated sooner rather than later. “The faster we can relieve the pain, the faster they’re able to get back to doing the things they enjoy and recapture their quality of life.”