Facet joint radiofrequency ablation, also called rhizotomy or neurotomy, is a minimally invasive procedure used to treat chronic neck or back pain caused by irritated or arthritic facet joints. The facet joints are small joints located at each level of the spine that help control movement and provide stability. When these joints become inflamed due to arthritis, degenerative changes, repetitive stress, or traumatic injuries such as motor vehicle accidents, they can cause persistent, localized pain that worsens with bending, twisting, or standing for long periods.

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During the procedure, the physician uses fluoroscopic (real-time X-ray) guidance to precisely position a specialized needle near the small medial branch nerves that transmit pain signals from the facet joints. Radiofrequency energy is then applied to gently heat and disrupt these pain-transmitting nerves. By interrupting the pain signals, the procedure can significantly reduce discomfort while preserving normal spinal stability and movement.

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Facet radiofrequency ablation is typically recommended after diagnostic medial branch blocks confirm that the facet joints are the source of pain and when conservative treatments such as medications, physical therapy, or injections have not provided lasting relief. Unlike temporary injections, radiofrequency ablation can provide longer-term improvement, with many patients experiencing relief for six months to a year or longer. As the nerves gradually regenerate over time, the procedure can be safely repeated if necessary.

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This treatment can improve mobility, reduce reliance on pain medications, and allow patients to return to daily activities with greater comfort and function.