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Pulsed radiofrequency - neuromodulation, not a burn.

A 42 °C, image-guided intervention for chronic neuropathic pain - dorsal root ganglion, occipital, suprascapular, genicular - by a consultant pain physician who does PRF weekly, not occasionally.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private PRF costs in the UK.

Indicative ranges across our partner pain units.

In short

Single-level DRG PRF: £1,600–£2,600, home same day.

Procedure Indicative range
Diagnostic nerve or DRG block (first step) £450–£850
PRF of dorsal root ganglion (single level) £1,600–£2,600
PRF of dorsal root ganglion (two levels) £2,200–£3,400
PRF of occipital nerve (bilateral) £1,400–£2,200
PRF of suprascapular nerve £1,500–£2,400
PRF of genicular nerves (knee) £1,800–£2,800
Pain consultation only £250–£450

Prices vary by hospital, by consultant, by target and by whether a diagnostic block was combined at the same sitting.

The problem

The right target, honestly selected - not a shotgun approach.

PRF works best when a preceding diagnostic block has abolished your pain, when the pain generator is truly neuropathic and when your operator does the technique routinely.

  • Block first, treat second

    A short-acting diagnostic block confirms the target. If the block does not help, PRF is unlikely to.

  • Neuropathic - not mechanical

    PRF is for burning, shooting, shock-like pain. Mechanical back pain from arthritis needs a different plan.

  • Set expectations honestly

    Expect 30 to 70 percent pain reduction for 3 to 12 months in responders. That is a good result - not a cure.

When it helps

When pulsed radiofrequency is the right step.

The situations we see most, plus the one red flag that means A&E rather than a routine pain appointment.

  • Cervical or lumbar radicular pain

    Persistent nerve-root pain with a positive diagnostic block, especially where an epidural steroid has helped only briefly.

  • Occipital neuralgia

    Sharp shooting pain in the greater or lesser occipital distribution, unresponsive to injections and neuropathic drugs.

  • Shoulder pain from suprascapular neuropathy

    Chronic shoulder pain with a positive diagnostic block of the suprascapular nerve - often after failed rotator cuff surgery.

  • Knee pain from osteoarthritis

    Genicular PRF for knee OA in patients not yet ready for, or unfit for, joint replacement.

  • Post-herpetic neuralgia

    Neuropathic pain persisting after shingles, especially in the thoracic dermatomes.

  • Post-surgical neuropathic pain

    Chronic groin, chest wall or scar-related nerve pain after hernia repair, thoracotomy or mastectomy.

  • Complex regional pain syndrome

    Selected CRPS cases where a sympathetic block has helped and PRF of the DRG is the next step.

  • Red flag: new weakness, fever or bladder change

    New motor deficit, saddle numbness, bladder or bowel change, or fever with back pain is A&E, not a PRF clinic - call 999 or 111.

Procedure options

Target follows pain generator.

What each option involves - the anatomical target and the pain pattern it best serves.

  • PRF of the dorsal root ganglion (DRG)

    The workhorse - a needle placed in the neural foramen at the target spinal level, delivering 2 to 4 minutes of pulsed 42 °C RF adjacent to the DRG. Neuromodulatory, not destructive.

  • PRF of occipital nerves

    Greater and lesser occipital PRF for chronic migraine, cervicogenic headache and occipital neuralgia. Ultrasound-guided in the sub-occipital tissue plane.

  • PRF of suprascapular nerve

    Ultrasound-guided in the suprascapular notch. Effective for chronic shoulder pain where surgery is not indicated.

  • PRF of genicular nerves

    Superior medial, superior lateral and inferior medial genicular branches around the knee. Used for OA pain and post-arthroplasty pain.

  • PRF of trigeminal branches

    Sphenopalatine ganglion, maxillary or mandibular branches for facial pain. Trigeminal PRF is a specialist niche in high-volume UK pain units.

  • PRF of sacroiliac and pudendal nerves

    For SI joint pain confirmed on diagnostic block, and for pudendal neuralgia after conservative failure.

  • Combined PRF and continuous RF

    For medial branch pain of the facet joints, some operators use continuous RF (a controlled thermal lesion), reserving PRF for DRG and mixed nerves where motor fibres must be preserved.

  • Water-cooled PRF

    Larger lesion volume for genicular and sacroiliac targets, with an active cooling circuit to prevent tissue charring.

Safety and recovery

What to expect afterwards - honestly.

PRF is intentionally sub-lesional and image-guided. The things worth planning are patient selection, honest expectations and a clear next step if response is poor.

  • Local anaesthetic and light sedation

    Almost always awake with local. Sedation is on request but rarely needed once you understand what is happening.

  • Bruising and post-procedural soreness

    Local soreness at the needle site for 24 to 48 hours in most patients - settles with paracetamol and ice.

  • Transient increase in pain

    A small proportion notice a temporary flare in the first week. Not failure - often precedes the response.

  • Nerve or vessel injury (rare)

    PRF is intentionally sub-lesional at 42 °C, so permanent nerve injury is very uncommon. Vessel injury is rare with modern imaging guidance.

  • Bleeding on anticoagulants

    Warfarin, DOACs and antiplatelet agents are reviewed case by case. Most can continue for peripheral targets; DRG PRF usually needs a short hold.

  • Infection is very rare

    Full sterile technique, single-use kit, no antibiotic prophylaxis routinely needed.

  • Effect size - be realistic

    Expect 30 to 70 percent pain reduction for 3 to 12 months in responders. Not a cure. Best used as part of a broader pain plan.

  • Repeatability

    PRF can be repeated when the effect wears off. Most units allow a repeat at 4 to 6 months if response was clinically meaningful the first time.

  • Red flags after the procedure

    Fever, spreading redness, new weakness, bladder or bowel change need the same-day team or A&E, not a routine call.

Reading your procedure note

Your PRF note in four parts. Read the last one first.

Whichever target was treated, the note the pain physician sends you keeps to the same shape.

A UK consultant pain physician reviewing fluoroscopic images after PRF

A quiet reminder

Interventional pain notes can read coldly - we translate them for you.

If you would like us to talk you through the procedure note and pain diary interpretation, just ask.

  1. 01 Header

    Target, laterality and imaging modality

    Which nerve or DRG was treated, side, and whether fluoroscopy or ultrasound was used.

  2. 02 Technique

    Access, testing and dosing

    Needle path, sensory testing at 50 Hz and motor testing at 2 Hz to confirm placement, and the PRF dose (42 °C, 2 to 4 minutes per cycle).

  3. 03 Findings

    Response to intra-procedural testing

    Whether stimulation reproduced your usual pain distribution - the best predictor of durable response.

  4. 04 Impression

    Follow-up, diary and next step

    Read this first: your pain diary instructions, follow-up call at 4 weeks, and criteria for a repeat PRF or step-up to neuromodulation.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

PRF cover varies - some insurers approve DRG and genicular PRF straightforwardly, others require prior injection trials.

Frequently asked

Everything we get asked about pulsed radiofrequency.

Quick answers on how it differs from conventional RF, success rates, timing, cost and recovery.

  • What is pulsed radiofrequency and how is it different from conventional RF?

    Pulsed radiofrequency delivers short bursts of high-frequency current that heat the tissue only to 42 °C - below the threshold for thermal damage. Conventional RF creates a controlled burn at 80 °C or so. PRF is neuromodulatory: it changes how the nerve processes pain signals without destroying it, which is why it is used on mixed sensory and motor nerves and on the dorsal root ganglion.

  • How well does it work?

    Around 55 to 70 percent of well-selected patients get a meaningful reduction in pain - usually 30 to 70 percent - lasting 3 to 12 months. Response is much more likely when a preceding diagnostic block has abolished the pain. It is not a cure; it is a durable pain modulator that fits into a broader plan.

  • When would you choose PRF over an epidural steroid injection?

    Epidural steroid is usually first-line for acute radicular pain where inflammation dominates. PRF becomes the answer for the neuropathic component that persists - burning, shooting, shock-like pain that continues once the inflammatory picture has settled and steroid effects have faded.

  • How much does private pulsed radiofrequency cost in the UK?

    Roughly £1,400 to £2,200 for occipital PRF, £1,500 to £2,400 for suprascapular, £1,600 to £2,600 for a single-level DRG, £1,800 to £2,800 for genicular, and £2,200 to £3,400 for two-level DRG. A diagnostic block is £450 to £850.

  • What is the recovery like?

    Home within 1 to 2 hours. Local soreness for 24 to 48 hours. Back to office work next day, driving next day, light exercise at 3 to 5 days. Full activity by a week.

  • Can PRF be repeated?

    Yes. Most UK pain units allow a repeat at 4 to 6 months if the first PRF gave a clinically meaningful response. Some patients get progressively longer intervals between sessions as central sensitisation calms down.

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