What is Radiofrequency neurotomy

Radiofrequency neurotomy is a procedure to reduce back and neck pain. Heat generated by radio waves is used to target specific nerves and temporarily interfere with their ability to transmit pain signals.

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.

Radiofrequency neurotomy works better in some people than in others. Tests may be needed to determine if the nerves commonly targeted by radiofrequency neurotomy are the same nerves responsible for your pain.

Radiofrequency neurotomy is usually done by doctors who specialize in treating pain. The goal is to temporarily reduce chronic pain in the back or neck that hasn’t been adequately relieved by other means, such as medications or physical therapy.

Radiofrequency neurotomy might be recommended to treat neck pain associated with whiplash. The procedure also might be recommended for back pain that:

  • Occurs on one or both sides of your lower back
  • Extends into the buttock region and thighs but not usually past the knee
  • Worsens if you twist or lift something
  • Improves when you’re lying down

Common side effects include:

  • Temporary numbness
  • Pain at the procedure site

Rarely, more-serious side effects occur, including:

  • Bleeding
  • Infection
  • Long-term numbness
  • Paralysis
  • Nerve injury

To determine if you’re a good candidate for radiofrequency neurotomy, your doctor may perform a test to see if the nerves commonly targeted by the procedure are the same nerves responsible for your pain.

This test involves injecting a small amount of numbing medication into the precise spots where the radiofrequency needles will go. If your pain significantly lessens, radiofrequency treatment at those spots may help you.

Before the procedure, you should:

  • Avoid chewing gum or using tobacco products on the day of the procedure
  • Avoid using deodorants, lotions or perfumes on the day of the procedure
  • Use clear liquids to take any medications up to two hours before your procedure
  • Arrange for someone to drive you home

During radiofrequency neurotomy

Radiofrequency neurotomy is an outpatient procedure, so you’ll go home later that same day. The procedure usually takes about an hour.

You’ll wear a hospital gown and lie on your stomach on an X-ray table. A special X-ray machine (fluoroscope) will help the doctor position the radiofrequency needles precisely — so only the targeted nerve tissue will be affected.

An intravenous (IV) line will be placed in your arm or hand to deliver medication that will keep you comfortable during the procedure. Numbing medication will be injected into your skin before the radiofrequency needles are inserted.

After radiofrequency neurotomy

You’ll be taken to another room to rest until you feel ready to go home. You might notice some soreness in the area where the needles were inserted, but this usually goes away in a day or two.

When you get home:

  • Use an ice pack on the injections sites if you have discomfort. Your doctor may recommend using the ice pack for 20 minutes three or four times during the first 24 hours after your procedure.
  • Avoid using a heating pad on the injection sites.
  • Avoid baths for two days. You may take a warm shower 24 hours after your procedure.

Radiofrequency works better for some people than others. A key factor is whether the nerves targeted by the procedure are the same nerves responsible for your pain.

Symptom relief is temporary, usually lasting six to nine months. Repeated treatments generally have similar results.