Radiofrequency Neurotomy of the Lumbar Facets

Radiofrequency Neurotomy of the Lumbar Facets is a minimally invasive procedure that uses controlled heat energy to interrupt pain signals from small nerves supplying the facet joints in the lower back. These nerves, called medial branch nerves, can become irritated by arthritis or degenerative changes, causing chronic back pain. By precisely targeting and deactivating these nerves, this treatment can provide long-lasting pain relief and improved function for patients with confirmed facet-related pain.

Quick Facts

  • Setting: Outpatient, image-guided
  • Time: ~30–45 minutes
  • Anesthesia: Local with optional light sedation
  • Recovery: Same-day discharge; mild soreness for several days
  • Duration of relief: Typically 6–12 months, sometimes longer

Who It Helps

  • Chronic lower back pain due to facet joint arthritis or degeneration
  • Pain that worsens with standing, twisting, or bending backward
  • Patients who experienced temporary relief from medial branch blocks
  • Persistent pain not improved by medication or therapy

How It Works

Facet joints connect the vertebrae and help stabilize the spine. When these joints become inflamed, the medial branch nerves that carry their pain signals can be safely targeted with radiofrequency energy. During the procedure, your provider uses fluoroscopic (X-ray) guidance to position specialized needles near the affected nerves. Controlled radiofrequency energy generates gentle heat, which deactivates the nerves’ ability to transmit pain. The joints themselves remain unharmed, and the nerves typically take months to regenerate.

What To Expect

  • Before: Your provider will review your medical history and confirm candidacy based on diagnostic medial branch block results. You may need to pause certain medications prior to the procedure.
  • During: You’ll lie comfortably on your stomach. The area is cleaned and numbed with local anesthetic. Using X-ray guidance, your provider places a thin probe next to each targeted nerve and applies brief radiofrequency energy to deactivate it.
  • After: You’ll rest briefly before going home. Mild soreness at the injection site is common for several days. Pain relief usually develops gradually over 2–4 weeks as the nerves fully deactivate.

Benefits & Risks

Benefits:

  • Provides longer-lasting relief than diagnostic injections
  • Minimally invasive with short recovery time
  • Improves mobility and reduces reliance on pain medication
  • Outpatient procedure with no incisions or stitches

Risks:

  • Temporary soreness or numbness
  • Infection or bleeding (rare)
  • Nerve irritation or temporary increase in pain
  • Rarely, incomplete pain relief

Is It Right For Me? (Checklist)

  • ✅ Chronic low back pain linked to facet joint degeneration
  • ✅ Confirmed relief from prior medial branch diagnostic blocks
  • ✅ No contraindications to radiofrequency treatment
  • ✅ Seeking long-term pain reduction without surgery

Alternatives At PCET

FAQs

  • Is this the same as a nerve ablation? Yes—radiofrequency neurotomy and nerve ablation refer to the same process of deactivating pain-transmitting nerves.
  • How long does relief last? Most patients experience 6–12 months of relief, sometimes longer, before nerves regenerate.
  • Can it be repeated? Yes, the procedure can safely be repeated if pain returns.
  • When will I feel improvement? Relief typically develops over several weeks as nerves are fully deactivated.
  • Is it covered by insurance? Most insurance plans, including Medicare, cover this procedure when medical criteria are met.

What Happens Next?

After Lumbar Facet Radiofrequency Neurotomy, your provider will review how your low back pain responds over the following weeks and whether you notice improvement in movement, stiffness, or daily activities.

If you experience meaningful relief, your provider may discuss follow-up care, physical therapy, functional rehabilitation, or whether the procedure could be repeated if pain returns over time.

If you do not get the relief you were hoping for, that does not mean you are out of options. Your provider may reassess whether your pain is coming from another source or whether a different treatment path may be more appropriate.

Possible next steps may include:

  • Reviewing your symptoms and imaging again
  • Evaluating other possible pain sources
  • A different injection or procedure
  • Physical therapy or functional rehabilitation
  • Other treatment options available through PCET

The goal is to better understand your pain and determine the next best step for your care.

📞 Call to Schedule

If you suffer from chronic lower back pain due to facet joint arthritis, Radiofrequency Neurotomy may offer long-lasting relief. Call us at 865-934-2567 to schedule your appointment today.