What is it?

Medial Branch Neurotomy, also referred to as Facet Rhizotomy, is a process that de-innervates the facet joints and cauterizes the medial branch of the dorsal ramus by means of Radiofrequency ablation (RFA) or any other method.

This technique damages the sensory nerve so pain to completely get rid of the pain. Medial Branch Neurotomy has several benefits; however, there are also a few risks that the patient must be aware of before undergoing the procedure.

Back or neck pain can be due to several problems with certain nerves that lie close to your spine. In this case, the doctor usually recommends blocking a nerve to predict your response to neurotomy. There are several factors that are involved in the treatment such as radiofrequency, heat or chemicals to demolish the nerves close to a problem joint. The process helps to keep a few pain messages from making their way to the brain and significantly relieves symptoms.

Every vertebra in the spine comprises of facets and they come into contact where the vertebrae fit together to form a facet joint. All facet joints have a minimum of two medial branch nerves each are part of the nerve trail. When a facet joint in the neck or back gets swollen, pain messages move along the pathway of nerves from the joint to the brain.

Destroying a few of these nerves that carry pain messages in every facet joint helps to restrict some pain messages to get to the brain. The process brings relief to the patient that can typically last for months to years.

Am I a candidate?

Typically, a patient has to experience improvement in pain for at least 80% during the initial 4 to 6 hours following the injection, after which he can be declared eligible for radiofrequency neurotomy.

How long does it take?

The complete procedure takes around 30 minutes. The medial branch nerves are numbed so you feel no or little pain when the nerve gets heated (or destroyed) for one minute. The procedure is generally repeated for one to five additional nerves.

A needle is first placed alongside the target nerve to deliver the medication directly to where they will have the most effect. Later, a physician injects a local anesthetic with a powerful anti-inflammatory steroid, next to the target nerve. This is a non-invasive process that offers a less intensive substitute to surgery.


In case the region where you got the injection administered hurts for the first couple of days following the shot, applying ice to the area can reduce any swelling and numb the pain. Patients can return to their daily routine on the day of the procedure.

Final Thoughts

Doctors recommend indulging your day to day activities and perform exercises in moderation. There are many rehab exercises that are incorporated to prevent the pain from returning at the time of nerve regeneration.