Radiofrequency Neurotomy

How can this procedure help my pain?

Radiofrequency neurotomy is performed to relieve pain to the nerves associated with facet joints. The facet joints are pairs of small joints situated at each vertebra of the spine; each set of facet joints is connected to two nerves that carry signals from the spine to all parts of the body. The nerves connected to facet joints can become painful due to arthritis, surgery, a back injury or repetitive stress to the back.

How is this procedure performed?

Radiofrequency neurotomy is another type of injection procedure, but uses electricity and heat rather than medicine to relieve pain. By applying small electrical impulses and heat to the two nerves within a facet joint, the effect is the interruption of pain signals to the brain. Radiofrequency neurotomy is best performed under fluoroscopy, which allows the doctor to obtain real-time moving images of the needle placement, and is performed in a sterile operating room as an outpatient procedure.

Prior to the procedure, the patient will be given a sedative to help them relax. The area where the needle will be placed is numbed with a local anesthetic. Once it takes effect the physician inserts a special needle next to the nerves experiencing the chronic pain. A small amount of electrical current is then passed through the needle, causing a brief muscle twitch in the neck or back. The nerves will then be numbed with a small amount of anesthetic, followed by heating the needle to 50 or 60 degrees for 90 to 120 seconds. The procedure is then repeated for the additional nerves as needed.

How long will this procedure take?

The entire procedure takes between 30 and 90 minutes. Afterwards, the patient is instructed to rest, and will need to be evaluated before given permission to leave. The patient should expect to feel drowsy and experience some numbness afterwards. It is recommended they avoid driving or operating any heavy machinery for at least 12 hours. If there is any discomfort at the injection site, the patient can use ice packs or wet heat for relief. Normal activities can resume 12 to 24 hours after the procedure.

Full pain relief from radiofrequency neurotomy will not typically occur until about two to three weeks after the procedure. Although the nerves will eventually regenerate, the patient’s pain may not necessarily recur. If the pain does recur, a second neurotomy can be performed.