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What Is Radiofrequency Neurotomy?

Radiofrequency neurotomy is an interventional pain procedure that uses controlled radiofrequency heat to interrupt selected sensory nerve fibers carrying pain signals. It is also called radiofrequency denervation or radiofrequency ablation in pain medicine. The procedure is most commonly used on medial branch nerves that supply painful spinal facet joints, although related techniques can target other sensory nerves. The nerve is not surgically removed, and pain can return when nerve fibers regenerate over time.

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What Is Radiofrequency Neurotomy?

Radiofrequency neurotomy is an interventional pain procedure that uses controlled radiofrequency heat to interrupt selected sensory nerve fibers carrying pain signals. It is also called radiofrequency denervation or radiofrequency ablation in pain medicine. The procedure is most commonly used on medial branch nerves that supply painful spinal facet joints, although related techniques can target other sensory nerves. The nerve is not surgically removed, and pain can return when nerve fibers regenerate over time.

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Why Is Radiofrequency Neurotomy Performed?

The procedure is considered for selected patients with chronic facet-mediated neck or low back pain that persists despite conservative treatment. Diagnostic medial branch blocks are commonly used before neurotomy to test whether temporarily numbing the targeted nerves produces meaningful pain relief. Evidence suggests radiofrequency denervation can reduce facet-related pain in some appropriately selected patients, but the average benefit is variable and some recent reviews describe only small improvements compared with control treatments. Patient selection, diagnostic criteria, technique, pain duration, and the underlying pain generator can all influence the outcome.

How Is Radiofrequency Neurotomy Performed?

The patient lies on a procedure table while fluoroscopy or another imaging method guides special radiofrequency needles toward the target sensory nerves. Electrical stimulation can be used to confirm proximity to the intended nerve and reduce the chance of treating a motor nerve. Local anesthetic is injected, and the electrode tip then heats tissue around the target to create a small controlled lesion that interrupts nerve conduction. Several nerves are often treated because each painful facet joint receives sensory input from more than one medial branch level.

What Is Recovery Like After Radiofrequency Neurotomy?

Patients usually go home the same day after a short observation period. Temporary soreness, burning, numbness, or increased pain can occur for several days while the treated tissues settle. Pain relief is not always immediate and can take days to weeks to become clear. When the procedure works, relief can last for months, but symptoms can return as the treated nerves regenerate and repeat neurotomy can be considered in selected patients.

What Are the Risks and Complications?

Possible complications include bleeding, infection, temporary numbness, localized neuritis, increased pain, and failure to improve symptoms. Incorrect needle placement can injure nearby sensory or motor nerves, although imaging and stimulation are used to reduce this risk. Because spinal medial branch nerves also supply small paraspinal muscles, there is ongoing research into whether denervation can affect muscle structure or function. Serious neurologic injury is uncommon but remains possible with poorly positioned needles or unintended thermal damage.

Frequently Asked Questions About Radiofrequency Neurotomy

How long does radiofrequency neurotomy last?

Pain relief commonly lasts several months in responders, but duration varies because the treated nerves can regenerate over time.

Why are diagnostic nerve blocks done before radiofrequency neurotomy?

Medial branch blocks temporarily numb the suspected pain-carrying nerves and help determine whether the targeted facet joints are likely to be the main source of pain.

Does radiofrequency neurotomy permanently destroy a nerve?

No. It creates a controlled thermal lesion that interrupts nerve conduction, but peripheral sensory nerve fibers can regenerate and pain can return.

Can radiofrequency neurotomy be repeated?

Yes. Repeat treatment can be considered when a prior procedure produced meaningful relief and pain later returns after nerve regeneration.

References

Radiofrequency neurotomy. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/radiofrequency-neurotomy/about/pac-20394931. Date Accessed September 11, 2026.

Radiofrequency Ablation. StatPearls (NCBI Bookshelf). https://www.ncbi.nlm.nih.gov/books/NBK482387/. Date Accessed September 11, 2026.

Consensus practice guidelines on interventions for lumbar facet joint pain from a multispecialty, international working group. PubMed. https://pubmed.ncbi.nlm.nih.gov/32245841/. Date Accessed September 11, 2026.

Updated 2026 Comprehensive Evidence-Based Guidelines for Facet Joint Interventions in the Management of Chronic Spinal Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines. PubMed. https://pubmed.ncbi.nlm.nih.gov/42370930/. Date Accessed September 11, 2026.

Current evidence on radiofrequency denervation for chronic low back pain: a systematic review and meta-analysis. PubMed. https://pubmed.ncbi.nlm.nih.gov/42463214/. Date Accessed September 11, 2026.