Radiofrequency Neurotomy Explained: How It Works and What to Expect

Chronic pain can be both exhausting and limiting, especially when traditional therapies such as medications, physical therapy, or injections do not provide lasting relief. For many patients with back, neck, or certain joint pain, radiofrequency neurotomy—also known as radiofrequency ablation (RFA)—offers a minimally invasive solution designed to reduce pain and restore mobility.

In this article, we’ll explain what radiofrequency neurotomy is, how it works, and what you can expect before, during, and after the procedure.

What Is Radiofrequency Neurotomy?

Radiofrequency neurotomy is a minimally invasive pain management technique that uses heat generated by radio waves to disrupt the nerves transmitting pain signals. By targeting these specific nerves, the procedure reduces or eliminates pain in the affected area without damaging nearby structures.

It’s most commonly used to treat:

• Chronic low back pain caused by arthritis in the facet joints
• Neck pain related to cervical facet arthritis
• Pain from sacroiliac joint dysfunction
• Certain types of chronic knee or hip pain

How Does Radiofrequency Neurotomy Work?

1. Targeting the Pain Source: Pain often originates from small nerves that branch from arthritic joints in the spine or other areas. Before RFA, physicians usually perform diagnostic nerve blocks (injections of numbing medication) to confirm the source of pain.
2. Delivering Controlled Heat: During the procedure, a thin needle is inserted near the target nerve using fluoroscopy (X-ray guidance). A radiofrequency current passes through the needle, generating heat that carefully deactivates the nerve’s ability to send pain signals.
3. Selective Precision: The goal is to treat only the nerves contributing to pain while preserving normal nerve function in nearby tissues.

What to Expect Before the Procedure

• Initial Evaluation: A pain specialist will review your medical history, perform an exam, and confirm the pain source with diagnostic nerve blocks.
• Preparation: You may need to stop blood-thinning medications temporarily and arrange for someone to drive you home.
• Sedation: The procedure is typically performed with local anesthesia and sometimes light sedation, keeping you comfortable while awake.

What to Expect During the Procedure

• You’ll lie on a procedure table while the physician uses imaging guidance to position the needle precisely.
• A test stimulation may be done to ensure accuracy—you may feel a tingling sensation.
• Once confirmed, the radiofrequency energy is applied for 60–90 seconds at each target nerve site.
• The entire procedure typically lasts 30–60 minutes.

What to Expect After the Procedure

• Recovery: Most patients go home the same day. Mild soreness at the injection site is common for a few days.
• Pain Relief Timeline: Some patients notice improvement within a week, while others may take up to three weeks as the treated nerves stop transmitting pain signals.
• Duration of Relief: Pain relief can last 6–12 months, and in some cases even longer. Because nerves can regenerate over time, the procedure may need to be repeated if pain returns.
• Activity: You can usually resume light activities the next day, with gradual return to normal exercise and work.

Benefits of Radiofrequency Neurotomy

• Minimally invasive, no surgical incision
• Outpatient procedure with quick recovery
• Reduces or eliminates pain medication use
• Improves mobility and quality of life
• Long-lasting relief compared to steroid injections

Potential Risks and Side Effects

While generally safe, possible risks include:

• Temporary numbness or soreness
• Minor bleeding or infection at the needle site
• Rare nerve injury or worsening pain

Is Radiofrequency Neurotomy Right for You?

Radiofrequency neurotomy is best for patients with chronic pain linked to arthritis or joint dysfunction that has not responded well to other conservative treatments. If diagnostic nerve blocks have provided temporary relief, you may be an excellent candidate.

Final Thoughts

Radiofrequency neurotomy is an advanced treatment that provides long-lasting pain relief for many people living with chronic spine or joint pain. By targeting the nerves responsible for pain signals, this procedure helps restore function, reduce medication reliance, and improve overall quality of life.

If you struggle with persistent pain and want to explore your options, consult a pain management specialist to see if radiofrequency neurotomy may be right for you.