06 Apr What Is Radiofrequency Ablation (Rhizotomy) and How Long Does Relief Last?
Chronic back or neck pain that keeps coming back despite injections, physical therapy, or medication is exhausting. If you have been told that radiofrequency ablation might help, or if you have seen the term “rhizotomy” in your treatment notes and are not sure what it means, this post is for you.
Radiofrequency ablation is one of the most effective long-duration pain relief options available in interventional pain management. Here is a clear breakdown of how it works, who it is appropriate for, and what you can realistically expect in terms of results.
Radiofrequency Ablation and Rhizotomy: Are They the Same Thing?
Yes. Radiofrequency ablation (RFA) and rhizotomy refer to the same procedure. Rhizotomy is the clinical term for interrupting a nerve’s ability to transmit pain signals. Radiofrequency ablation describes the specific method used to accomplish that: applying heat generated by radio waves to disable the targeted nerve.
You may also hear it called radiofrequency neurotomy. All three terms describe the same treatment.
How Does Radiofrequency Ablation Work?
The nerves most commonly targeted by RFA are the medial branch nerves, which are the small nerve branches that carry pain signals from the facet joints of the spine to the brain. Facet joints connect the vertebrae to one another and allow the spine to flex and rotate. When these joints become arthritic or inflamed, the medial branch nerves transmit that pain continuously.
During the procedure, a physician uses fluoroscopic (X-ray) guidance to place a thin needle precisely alongside the targeted nerve. A radiofrequency current is then delivered through the needle, heating the nerve tissue to a temperature that disrupts its ability to send pain signals. The nerve is not destroyed permanently, but its function is interrupted for an extended period.
The procedure is performed under light sedation or local anesthesia. Most patients are in and out of the clinic within one to two hours and can return to normal activities within a few days.
Who Is a Good Candidate?
Radiofrequency ablation is not appropriate for every type of back or neck pain. It works best when the source of pain has been accurately identified as the facet joints or sacroiliac joints. Because of this, most physicians require that a patient first undergo diagnostic medial branch blocks, which are targeted injections of local anesthetic near the suspected nerve. If those blocks provide significant, temporary relief, it confirms that the medial branch nerve is the correct target and that RFA is likely to be effective.
You may be a good candidate for RFA if:
- You have chronic neck, mid-back, or low back pain that has been traced to the facet joints
- Diagnostic nerve blocks confirmed your pain source
- You have not found lasting relief from physical therapy, oral medications, or steroid injections alone
- You want to avoid or delay surgery
- Your pain significantly limits your daily function, work, or sleep
How Long Does Relief Last?
This is the question most patients ask first, and the honest answer is that it varies. For most patients, radiofrequency ablation provides meaningful pain relief for six months to two years. Studies consistently show that a significant percentage of patients experience at least 50 percent reduction in pain for twelve months or longer.
The reason relief is not permanent is that nerves can regenerate over time. As the medial branch nerve gradually regrows, pain signals may begin to return. The good news is that the procedure can be repeated. Many patients undergo RFA every one to two years and maintain a substantially improved quality of life as a result.
Factors that influence how long relief lasts include the accuracy of nerve targeting, the degree of joint degeneration, the patient’s overall health, and how closely post-procedure rehabilitation guidance is followed.
What to Expect After the Procedure
Some patients experience immediate relief. Others notice that pain temporarily increases for several days before improvement begins, as the treated tissue settles. Full benefit is typically felt within two to four weeks.
Common post-procedure experiences include:
- Mild soreness at the injection site for several days
- Occasional muscle spasm near the treated area
- Gradual, progressive reduction in the chronic pain that brought you in
Serious complications are rare when the procedure is performed by an experienced, fellowship-trained interventional pain physician using fluoroscopic guidance.
RFA at Principal Spine and Pain Consultants
At Principal Spine & Pain Consultants, Dr. Paul Kurian performs radiofrequency neurotomy as part of a comprehensive, patient-specific treatment approach. The goal is never to simply manage pain indefinitely. It is to give you back the function, sleep, and daily life that chronic pain has taken from you, using the most precise and least invasive tools available.
If you have been living with facet joint pain, arthritis-related back pain, or neck pain that has not responded to other treatments, radiofrequency ablation may be the answer worth exploring.