Radiofrequency Neurotomy

About Radiofrequency Neurotomy

Radiofrequency neurotomy is a procedure to reduce back and neck pain. It uses heat generated by radio waves to damage specific nerves and temporarily interfere with their ability to transmit pain signals.

In radiofrequency neurotomy, the radio waves are delivered to the targeted nerves via needles inserted through the skin above your spine. Imaging scans are used during radiofrequency neurotomy to help the doctor position the needles precisely.

Genucular radiofrequency ablation for chronic knee arthritis pain

Radiofrequency Neurotomy for Facet/Sacroiliac Joint Pain

As with many spinal injections, radiofrequency neurotomy is best performed under fluoroscopy (live x-ray) for guidance in properly targeting and placing the needle (and for avoiding nerve injury or other injury). On the day of the injection, patients are advised to avoid driving and doing any strenuous activities. Patients may continue to take any normal medications except aspirin or any other blood-thinning medications, such as Coumadin.

The neurotomy procedure includes the following steps:

  • An IV line will be started so that adequate relaxation medicine can be given, as needed.
  • The patient lies face down on an x-ray table and the skin over the neck, mid-back, or low back is well cleaned.
  • The physician numbs a small area of skin with numbing medicine (anesthetic), which may sting for a few seconds.
  • The physician uses x-ray guidance (fluoroscopy) to direct a special (radiofrequency) needle alongside the medial or lateral branch nerves.
  • A small amount of electrical current will then be carefully passed through the needle to assure it is next to the target nerve. This should briefly recreate the usual facet joint or sacroiliac pain, and cause a muscle twitch in the neck or back.
  • The nerves will then be numbed to minimize the facet or sacroiliac joint pain while the lesion is being created. This process will be repeated for 1 to 5 additional nerves.

Radiofrequency Neurotomy Results and Follow-Up

On the day after the procedure, the patient may cautiously return to regular activities. The neck or back will usually be very sore during the next one to four days. This pain is usually caused by muscle spasms and irritability while the targeted nerves are dying from the heat lesion over the next 7-14 days.

The physician may give medicine to the patient to treat the expected soreness, and the physician may also instruct the patient on how to apply ice (or heat or warm towels) to the sore area to alleviate discomfort. Patients usually will want to rest for several days before returning to normal activities.