Back and neck pain are among the most common health complaints in the UK. They affect people of all ages, often interfering with work, daily activities, and sleep. While causes vary, two of the most frequent sources are the facet joints of the spine and the sacroiliac joints of the pelvis. When these joints become painful, the result can be a persistent ache that resists standard treatments such as tablets, physiotherapy, or injections. targeted and bespoke treatments.

For people in this situation, a treatment called radiofrequency ablation – sometimes referred to as denervation – may provide longer-lasting relief. The Manchester Pain Clinic has a well-established specialist service for back and neck pain.

A Specialist Service in Manchester 

At the Orth Team Centre in Manchester, pain consultant Dr Rajan performs over 200 radiofrequency ablation procedures every year. He also teaches these techniques nationally, helping other doctors to use them safely and effectively. Patients attending the Centre not only benefit from his individual expertise but, also from the wider team of specialists available under one roof.

Careful Assessment Before Treatment 

Every journey begins with a thorough clinic consultation. Here, symptoms, medical history, and any existing scans are reviewed in detail. If further imaging is needed, this can be arranged promptly. The aim is to identify the diagnostic target for back or neck pain. If facet joint-mediated pain is suspected, the aim is to determine whether the medial branch nerves supplying the facet joints are driving the pain.

To test this theory, many patients undergo diagnostic nerve blocks. These are short procedures where local anaesthetic is injected near the nerves thought to be involved. If pain improves – even for a few hours – it strongly suggests that radiofrequency ablation may be worthwhile.

How the Procedure Works

Radiofrequency ablation is carried out as a day-case procedure, meaning patients can usually go home the same day. Using X-ray guidance, very fine needles are placed with millimetre accuracy next to the small nerves. A carefully controlled pulse of radiofrequency energy is then delivered, which disrupts the nerves’ ability to send pain signals.

Importantly, these nerves do not control muscle strength or movement. Their role is predominantly sensory, so only the pain pathway is affected.

For many people, relief lasts 18 months to two years. If symptoms gradually return as the nerves regrow, the procedure can be repeated safely. But this window of pain relief is the opportunity that many patients need to rehabilitate, engage in physio, pilates and swimming to help return to function, in a way that was not possible before their treatment. 

A Patient’s Perspective 

Sarah, a 52-year-old teacher, had struggled with lower back pain for nearly a decade. Physiotherapy and medications gave only brief respite, and she was beginning to lose hope of returning to activities she once enjoyed. After assessment at the Orth Team Centre, diagnostic blocks confirmed her facet joints were the source of the problem. She underwent radiofrequency ablation with Dr Rajan and noticed a difference within ten days.

“Being able to sit through a school day without that constant ache was a huge relief,” she says. “I’ve even started swimming again, something I thought I’d lost for good.”

For Sarah, the benefit went beyond pain reduction: it provided the confidence to move more, cut down on tablets, and re-engage with life.

Support for Complex Cases

Not all back and neck pain is straightforward. For more challenging cases, the Orth Team Centre runs a Spinal Multidisciplinary Team (MDT) a ground breaking service harnessing expert opinion. Here, neuroradiologists, neurosurgeons, rheumatologists, and pain consultants review cases together. This collaborative model ensures that decisions are balanced and that no detail is overlooked.

Making the Most of pain Relief

Radiofrequency ablation is not a cure in itself, but it creates a valuable window of opportunity. During this time, patients are encouraged to:

• Gradually increase physical activity

• Taper unnecessary pain medication

• Build strength through targeted exercise

Activities such as swimming, Pilates, and paced walking can be particularly helpful. The Manchester Pain Clinic also connects patients with trusted physiotherapists to support rehabilitation and help maintain progress.

Tel: 0161 327 4307  /  www.manchester-pain-clinic.co.uk

The Orth Team Centre