What to Expect with Procedures


Facet Rhizotomy


The facet joints are often the primary source of pain for many back pain sufferers. Facet joints are small joints located in pairs on the back of the spine that provide stability to the spine and allow the spine to move and be flexible.

Depending on where the problematic facet joints are located, they can cause pain: in the mid-back, ribs, chest (thoracic facet joints), lower back, abdomen, buttocks, groin, legs (lumbar facet joints), neck, shoulders, and even headaches (cervical facet joints). If facet blocks (medial branch block) are successful in providing pain relief a Facet Rhizotomy could be indicated.

The goal of a Facet Rhizotomy, either lumbar, cervical or thoracic, is to provide pain relief by "shutting off" the pain signals coming from the joints. The pain relief experienced by most patients who have this procedure lasts 6-18 months.

Will the Facet Rhizotomy cure my pain?

No, the procedure will help to lessen your pain, making it easier for you to participate in physical therapy to help improve your condition. How much relief and for how long varies among patients depending on other medical conditions and the source of your pain, but it can provide significant relief for 6-18 months.

Are there any side effects or complications?

Yes, Facet Rhizotomy is very safe, but as with any medical procedures, it has risks. Serious complications, such as infection, allergic reaction, nerve damage, bleeding and paralysis are extremely rare.

How is a Facet Rhizotomy done?

Patients who are candidates for Rhizotomy typically have undergone several facet joint injections to verify the source and exact location of their pain.

First the skin will be cleaned with a special solution. This will feel cold. Then your skin will be numbed with a local anesthetic, this will induce a stinging and burning sensation for a few seconds. A needle with an electrode at the tip is placed alongside the small nerves to the facet joint. The electrode is then heated, with a technology called radiofrequency, to deaden these nerves that carry pain signals. The time required to do the procedure varies from patient to patient, but it will usually take 30-60 minutes.

When can I go back to my normal activities?

As soon as possible. The staff in the clinic will provide you with care instructions after the injection. Please follow them. We prefer you go back to your normal activities as soon as the next day. It is very important to keep your body active.

Is it safe?

Yes, but as mentioned before, complications might occur. Serious, but very rare complications can occur, such as nerve damage, infection, bleeding or paralysis. Our staff will discuss in detail the risks and benefits before scheduling this injection.

Will the Rhizotomy prevent me from having surgery?

The procedure is to lessen your pain, not to prevent surgery, since pain may or may not be the reason for surgery. Talk to the doctor before the procedure if you have any doubts.

I’ve had Rhizotomy before and it did not help. Should I do another one?

It will vary from patient to patient, but in some cases a second Rhizotomy procedure on a different level could help your pain. Talk to your doctor about the opportunity for another injection.

What if the procedure does not help my pain?

There are other therapies that we can use to manage your pain. Using different methods to treat your pain is the most successful way to relieve your pain and improve your quality of life. Other strategies to treat your pain include exercise, relaxation, and changing negative behaviors and thought patterns can help you cope better with pain.

Who should not have the injection?

  • If you are pregnant or breastfeeding.
  • If you have a severe allergic reaction to local anesthetics or steroids.
  • If you are taking a blood thinner, such as Warfarin (Coumadin), Enoxaparin (Lovenox), Clopidogrel (Plavix), etc; and your medical condition does not allow us to stop it few days prior to the procedure.
  • If you develop fever or any infection.

Contact our office if YOU experience:

  • A severe headache
  • A fever
  • Pain that is more severe than prior to the injection
  • Increased back pain or back stiffness

Go to the nearest Emergency Department or call 911 if you develop any new numbness, weakness, and/or paralysis in your arms or legs or lose control of your bladder or bowels.


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