Radiofrequency Ablation of the Third Occipital Nerve

• Purpose – To reduce chronic headaches and neck pain in a more permanent manner by interrupting nerve signals.

• Overview – Radiofrequency ablation of the third occipital nerve is a minimally invasive outpatient procedure that reduces headache by interrupting the nerve supply.  It does this by creating a nerve lesion with localized heat in order to interrupt the pain signals and weaken the pain perceived by the brain.

• Before the procedure – It is best to avoid eating within six hours of the appointment, with the exception of clear liquids until two hours before the procedure.

• Details – The procedure begins with the patient being connected to monitoring devices as well as skin temperature monitors for safety and comfort purposes. Anesthetics and IV sedation may be used if needed. Then, the injection site is numbed. Following the numbing solution, radiopaque dye may be used as a contrast solution under x-ray guidance to confirm the correct needle position and target the specific nerve that will be injected. Once the accurate location is determined, the anesthetic is injected. Then, localized heat will be generated, destroying the surrounding pain fibers.

• After the procedure – Numbness should only last a few hours until the anesthetic wears off. Once the anesthetic wears off, there may be mild discomfort that lasts for a couple of weeks. If needed, it is recommended to treat the discomfort with ice on the day of the procedure and moist heat a day after the procedure. Because this is an outpatient procedure, it is best to coordinate a ride home after the procedure. You should not drive or operate machinery for at least 24 hours after the procedure.
• Possible side effects – Risk of infection or bleeding at the site, swelling, or bruising.