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Medial Branch Radiofrequency Rhizotomy
ABOUT THIS PROCEDURE
Procedure Time: 1-2 Hours
Driver Required: Yes
Total Visit Time: 2-4 Hours
If a medial branch block confirmed that your facet joints are the source of your pain, this is the next step — and for most patients, the one that delivers real, lasting relief.
Here's what's happening in plain terms: the facet joints in your spine are sending pain signals to your brain through small nerves called medial branch nerves. Those nerves are doing their job — they're just carrying a signal you don't want anymore. This procedure uses controlled heat to interrupt that signal. Think of it like turning off a circuit breaker that won't stop tripping. The joint is still there. The arthritis is still there. But the wire carrying the pain message gets turned off.
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The heat is delivered through a small needle placed precisely under X-ray guidance. The needle tip heats up to a specific temperature and disrupts the nerve's ability to transmit pain. The nerve isn't destroyed permanently — over several months it slowly regenerates. But by then, most patients have experienced significant relief, often the most relief they've had in years. When the nerve does regenerate and pain returns, the procedure can be repeated with similar results.
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This procedure is only performed after a successful medial branch block has confirmed the diagnosis. We don't skip that step.
Benefits
Provides longer-lasting relief than injections alone — often six months to over a year
Targets the exact nerves confirmed as pain sources by your medial branch block
Minimally invasive — no incision, no general anesthesia, no hospital stay
Can significantly reduce or eliminate the need for daily pain medication
Allows many patients to return to activities they had given up
One of the most evidence-supported procedures in interventional pain management
What to Expect
1
Prep & Numbing
You'll be positioned face down on the procedure table. This procedure takes longer than a standard block, so the team will make sure you're comfortable and explain each step before starting.
2
Cleanse & Numbing
The skin is cleaned and a local anesthetic is used to numb the area before any needles are placed. The initial sting from the numbing shot is typically the most uncomfortable part of the entire procedure.
3
Needle Placement & Sensory Testing
Using live X-ray guidance, Dr. Savu positions radiofrequency needles at each medial branch nerve being treated. A small electrical current is then used to confirm correct placement — you may feel a buzzing or tingling sensation during this step, which is normal and expected.
4
radiofrequency treatment
Once placement is confirmed at each level, the needle tip is heated for a controlled period. Most patients feel mild warmth or pressure. The treatment at each nerve takes about 90 seconds and is repeated at each target level.
5
recovery & discharge
You'll rest in recovery before being released to your driver. Expect soreness at the injection sites for the next several days — this is normal and a sign the procedure was performed correctly. Discharge instructions will include guidance on managing post-procedure soreness.
This procedure may be right for you if you have:
Already had a successful medial branch block that confirmed facet joint pain
Chronic neck or back pain from facet joint arthritis or degeneration
Pain that responded well to a medial branch block but returned after the numbing wore off
A need for longer-lasting relief without surgery
Frequently Asked Questions
Don't expect immediate relief — this is different from an injection. The nerve needs time to settle after being treated. Most patients begin noticing improvement two to four weeks after the procedure, with full relief often developing over four to six weeks.
Most patients experience relief for six months to over a year. When the nerve regenerates and pain returns, the procedure can be repeated with similar results.
Yes, and that's expected. The treated area may feel worse before it feels better as the nerve settles. Over-the-counter pain relievers and ice can help. If soreness is severe or lasts more than a week, call the office.
Eat lightly before your appointment. Arrange a driver. Let the office know about blood thinners, aspirin, or anti-inflammatory medications. Continue routine medications for heart, diabetes, and blood pressure unless advised otherwise.
Normal soreness at the injection sites is expected for several days. Contact the office if you develop fever, chills, increasing redness or drainage at any injection site, new or worsening weakness, or any loss of bladder or bowel control.
