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Facet Radiofrequency Neurotomy
This minimally invasive procedure uses precisely applied radiofrequency energy (heat) to disrupt the small medial branch nerves responsible for transmitting pain signals from arthritic or injured facet joints.
What is a Facet Radiofrequency Neurotomy?
For patients who have found temporary relief through medial branch blocks or facet joint injections but want a longer-lasting solution, facet radiofrequency neurotomy offers a compelling next step. This minimally invasive procedure uses precisely applied radiofrequency energy (heat) to disrupt the small medial branch nerves responsible for transmitting pain signals from arthritic or injured facet joints. By interrupting that signal pathway, radiofrequency neurotomy can significantly reduce spinal pain — often providing relief that lasts months to over a year. At River Cities Interventional Pain Specialists, this procedure is performed with imaging guidance for maximum precision and safety.
What To Expect
The procedure is performed at Park Plaza Surgical Specialists under fluoroscopic guidance and typically takes 45–60 minutes. Here's what the process looks like:
✔️ You'll be positioned comfortably and given IV sedation to ensure you're relaxed throughout.
✔️ The skin over the target area is cleaned and numbed with local anesthetic.
✔️ Under fluoroscopic guidance, Dr. Brewer places a specialized radiofrequency needle alongside each target nerve.
✔️ Sensory and motor testing is performed to confirm accurate placement — you may feel a buzzing or pressure sensation.
✔️ Radiofrequency energy is applied in brief intervals, generating controlled heat that safely disrupts the nerve.
✔️ The procedure may be performed at multiple levels in a single session depending on your diagnosis.
Results and Recovery
Recovery from facet radiofrequency neurotomy is generally straightforward, though there is a brief recovery period. It's common to experience increased soreness at the treatment site for 1–3 weeks before relief sets in — this is a normal part of the healing process. Full benefit is typically felt 2–6 weeks after the procedure. Most patients return to desk work within a few days and resume full activity within 2–4 weeks. Because nerves have the capacity to regenerate, pain relief typically lasts 9–18 months. The procedure can be safely repeated if and when pain returns.
Facet radiofrequency neurotomy is an excellent option for patients who:
✔️ Have already experienced meaningful (at least 50–80%) pain relief from diagnostic medial branch blocks, confirming the facet joints as the pain source
✔️ Suffer from chronic neck or back pain related to arthritis, degenerative disc disease, or facet joint injury
✔️ Want longer-lasting relief than injections alone can provide
✔️ Are looking for a non-surgical solution that avoids the risks and recovery associated with spinal surgery
✔️ Have failed to achieve lasting relief through physical therapy and medications
WHO IS THIS BEST FOR?
Frequently Asked Questions
Yes, over time the targeted nerves can regenerate, and pain may gradually return — typically 9–18 months after the procedure. The good news is that radiofrequency neurotomy can be safely repeated, and many patients continue to experience excellent results with repeat treatments.
Facet radiofrequency neurotomy has a strong safety record and has been performed for over 30 years. The nerves targeted are purely pain-sensing — they don't control any motor functions — so disrupting them does not cause any weakness or loss of movement.
The most important indicator is your response to diagnostic medial branch blocks. If those injections gave you significant, if temporary, pain relief, radiofrequency neurotomy is likely to be effective for you. Dr. Brewer will review your history and imaging before making a recommendation.
Injections reduce inflammation and provide temporary relief lasting weeks to months. Radiofrequency neurotomy physically interrupts the nerve pathway transmitting pain, offering longer-lasting relief — often 9–18 months or more — without medication.
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