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Interventional Pain
Management Center

Patient Information Library

Radiofrequency Rhizotomy

What is a Radiofrequency Rhizotomy and how is it helpful?

Radiofrequency (RF) rhizotomy, or RF neurotomy, is a therapeutic procedure designed to decrease or eliminate pain symptoms within spinal facets.

The procedure involves using a needle to carefully place a small electrode adjacent to the facet under x-ray guidance. An electric current is then used to cauterize the sensory nerves that innervate the facet joint(s). If successful, the pain relief following an RF procedure can last considerably longer than relief following local anesthetic and steroid blocks. This process can be used on any area of the spine--cervical, thoracic, or lumbar.

Before patients can be scheduled for an RF rhizotomy procedure, they generally must undergo a series of facet injections and/or discography tests to verify the exact source of their symptoms. These tests may require several visits. If these tests have been performed elsewhere within 90 days of your exam, Dr. Chaudhry or another pain management physician will need to review the results. Because of the potential irreversibility of the rhizotomy, it is important to verify the exact nerve or nerves from which the symptoms originate. For this reason, some of these pre-procedure exams may need to be repeated by the pain management physician, who will later perform the RF procedure.

Due to the trauma to the nerve, you may experience an increase in symptoms for 5-7 days after the procedure. Pain relief benefits from the rhizotomy should be apparent within 2-4 weeks.

Who is an appropriate candidate for RF rhizotomy?

If you have experienced pain relief through therapeutic facet injections, but the relief was only short-term, then you may be a candidate for RF rhizotomy. Because RF has a very specific focus, when your symptoms arise from a number of sources, RF may not be an effective solution.

How does the pain management physician ensure that the needle is placed correctly?

The doctor places the needle adjacent to the nerve by mean of a fluoroscope (x-ray) connected to a television monitor. To ensure proper needle placement, the radiologist stimulates the nerve via an electrode, producing achy sensations which verify that the stimulated nerve is indeed the origin of the pain.

Is the procedure painful?

Due to the use of a local anesthetic the patient experiences very little sensation during the procedure itself, apart from an achy sensation as the needle is placed near the nerve. There may be some discomfort at the injection site once the anesthetic wears off.

What side effects could occur?

Possible side effects of the steroid medications include facial flushing, insomnia, and occasional low grade fever. These side effects are bothersome in only about 5% of patients and commonly disappear within 1-3 days after the injection.

To Learn More

If you are interested in an evaluation into the cause of your pain, please contact our pain management experts at Spine Associates in Houston, TX and Beaumont, TX.  We would be happy to make an appointment for a consultation and provide additional information about other treatment options.