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Neck pain treatment and procedures

Persistent neck pain, particularly after whiplash, most often arises from the cervical facet joints — and these can be tested directly. Dr Chris Martin provides cervical medial branch blocks, cervical radiofrequency rhizotomy, selected nerve root injections and treatment of neck-related headache, alongside rehabilitation.

In brief

The cervical facet joints are the most common source of persistent neck pain after whiplash and can be identified with diagnostic blocks.
Cervical radiofrequency rhizotomy provides months of relief for people whose blocks are positive, and can be repeated.
Headache arising from the upper neck is assessed and treated as part of the same picture.
Arm-dominant pain suggests a nerve root problem and is assessed and treated differently.
A normal scan is common in people with real, limiting neck pain — it means the responsible structure is not one a scan shows well.

Most neck pain after an injury settles within weeks. When it does not, the usual story is months of physiotherapy, a scan reported as showing only age-related change, and a growing sense that nobody can find anything. In many of these people the source is identifiable — the facet joints of the neck are strained in whiplash-type injuries in ways no scan shows, and research has repeatedly found them to be the most common cause of persistent post-whiplash pain.

Identifying the source

The level of the painful joint is suggested by where the pain is felt and by examination. It is then tested with a cervical medial branch block: a small volume of local anaesthetic placed under X-ray guidance beside the nerves supplying that joint. If the pain goes for the duration of the anaesthetic, the joint is the source. The result decides what follows.

Cervical radiofrequency rhizotomy

Where blocks identify a facet source, cervical radiofrequency rhizotomy interrupts the same nerves with heat, providing relief that commonly lasts six to twelve months and can be repeated as the nerves regenerate. Cervical rhizotomy requires precise technique — the procedure is performed under X-ray guidance with light sedation as a day case — and it is one of the more frequently performed procedures in this practice.

Headache from the neck

Headache arising from the upper cervical joints — cervicogenic headache — accompanies neck pain in many people and is treated on the same principles: diagnostic block of the upper cervical levels, then radiofrequency where the block is positive. Occipital nerve blocks are used where the pain pattern suggests occipital neuralgia. See migraine and headache treatment.

Arm pain: nerve root involvement

Pain that travels down the arm in a nerve distribution, with numbness, tingling or weakness, suggests an irritated cervical nerve root rather than a joint. This is assessed with examination and imaging, and selected nerve root injections are available for appropriate cases. Where there is progressive weakness, surgical opinion is arranged promptly.

Rehabilitation and the longer term

Deep neck flexor strengthening, posture and workstation changes, and graded return to activity determine how much of the relief from a procedure is kept. Rehabilitation planning is part of every neck pain plan here, and for motor vehicle and work-related injuries the practice is familiar with the reporting that insurers require.

Risks

Whilst pain procedures are generally safe and well tolerated, all procedures carry risks. The specific risks relevant to you and your procedure will be discussed with you, and written information provided, before you decide to proceed.

Common questions

My neck scan is normal. Can you still treat the pain?

Yes. The facet joints are strained in whiplash in ways MRI and X-ray do not show. Diagnostic blocks test the joints directly, and a positive block opens the way to radiofrequency treatment regardless of what the scan reported.

Is cervical rhizotomy safe?

It is an established procedure performed under X-ray guidance with light sedation. Like all procedures it carries risks, which are specific to the level treated and are discussed with you, with written information, before you decide.

How long does cervical radiofrequency last?

Relief commonly lasts six to twelve months, with wide individual variation. The treated nerves regenerate and the procedure can be repeated when pain returns.

Can neck pain cause headaches?

Yes. The upper cervical joints refer pain to the back and side of the head, and this cervicogenic headache is often misread as migraine or tension headache. It is tested with diagnostic blocks of the upper neck.

Is this covered under a motor vehicle or workers compensation claim?

Often. The practice is familiar with ICWA and WorkCover WA processes and provides the reporting required. Approval from the insurer is needed before procedures are booked.

Practical information

Where: Most procedures are performed as a day case at St John of God Subiaco Hospital, Hollywood Private Hospital, Mount Private Hospital or St John of God Midland Hospital; some smaller procedures are performed in the rooms at Mount Lawley. The setting is confirmed with you at booking.
Referral: Required from a GP or specialist — by Healthlink (EDI painmdwa), fax 08 6114 0717 or email. Routine appointments are generally available within two to four weeks.
Before the day: Fasting, medication and transport requirements are set out on Before your procedure. If you take blood-thinning medication, or diabetes or weight-loss injections, tell the practice well before the day.
Costs: Dr Martin is a no-gap provider for in-hospital procedures with all major health funds, subject to your level of cover. A fee estimate is supplied on booking, prior to your consultation. See Fees and billing.
Afterwards: If your procedure is under sedation you cannot drive for 24 hours afterwards — please arrange transport home. Written post-procedure instructions are provided.
Rural and remote: Assessment and review can be done by telehealth; the procedure itself is scheduled in Perth.

How to arrange an appointment

A referral from a GP or specialist is required. Referrals are accepted by Healthlink (EDI: painmdwa), fax 08 6114 0717 or email admin@painmedicinewa.com.

Enquiries: 0448 299 260 — Monday 9:00am – 4:00pm, Tuesday to Thursday 8:00am – 4:00pm.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

This page provides general information only and is not a substitute for individual medical advice. Whether a treatment is appropriate for you is a decision made in consultation with your doctor.

Reviewed by Dr Chris Martin, Consultant Pain and Rehabilitation Physician (FFPMANZCA, FAFRM RACP), Pain Medicine WA, Perth. Last reviewed October 2026.

In a medical emergency, call 000.