Radiofrequency ablation (rhizotomy or RFA) is a non-surgical procedure which damages the nerves (through very localized heating) that allow a person to feel pain that is caused by certain joints in the spine.  Before moving forward with this procedure, the joints have to be proven to be painful by diagnostic injection procedures.  It is important to determine that the pain cannot be significantly reduced or abolished by other treatment methods.  After the painful joints have been identified, their nerve supply is numbed to determine further if the radiofrequency ablation will be successful.

The rhizotomy prevents the pain signal from traveling through the nerves from a person’s joints to his/her brain so that the person cannot feel the injured and/or diseased spinal joints.  The nerves do not control any muscles or sensation in the arms or legs.  They only allow for feeling the joints and small nearby ligaments.

The procedure is performed at an outpatient facility.  An IV is started and a nurse will give an adequate amount of medicine to help the patient relax and some pain medicine.  After the skin is prepared with a cleanser, local anesthesia is given.  A special (radiofrequency) needle is guided using special X-ray equipment to the targeted nerve.  Small test currents are administered and the patient is asked questions about this stimulation.  The stimulation is generally not painful but will cause a muscle to twitch in the back or neck. After the testing is completed, the medial branch nerves will be numbed so that the patient will feel little to nothing where the nerve is being heated.

The patient goes home 30-60 minutes after the procedure and is remain at bed rest for approximately three days.  One may expect to be sore for the next one to four days.  The soreness is generally caused by muscle spasms and irritability during the time that the medial branch nerves are dying over the next seven to fourteen days.  Medicine will be given to help control this pain.  Pain relief is not usually experienced until two to four weeks after the procedure.

Reports indicate that in about one-half of patients, the pain never returns.  In others pain relief is obtained for 9-18 months.