ProcedureAblation & neuromodulation
Radiofrequency neurotomy
When blocks have confirmed that a facet joint is the source, radiofrequency neurotomy interrupts the small nerves that report its pain. It is the closest thing in spinal pain medicine to a durable, repeatable answer.
What it is
A fine insulated needle is placed alongside the medial branch nerve under X-ray guidance. Radiofrequency current heats the needle tip, creating a small, precise lesion that stops that nerve carrying the pain signal.
Motor nerve testing is performed before any heating, to confirm the position is safe.
Who it suits
- Confirmed facet joint pain in the neck or lower back
- Good but short-lived relief from diagnostic blocks
- Pain that has persisted despite an adequate rehabilitation attempt
On the day
Longer than a block, and more sensation is felt during the lesioning itself, so light sedation is commonly offered. Several levels can be treated in one sitting.
Afterwards
Expect a sore, bruised feeling for one to two weeks — that is the treated area settling, not a sign of failure. Relief typically builds from week two to week six.
The nerves regrow over time, and the procedure can be repeated when the pain returns. Rehabilitation during the relief period is what extends the benefit.
Risks
- Post-procedure soreness or neuritic burning for up to two weeks
- A patch of numbness over the treated area
- Small risk of no benefit, even after a positive block
- Bleeding or infection — uncommon
- Motor nerve injury — rare, and specifically tested against before lesioning
A note on this page
This is general information, written to help you prepare for a conversation. It is not a substitute for an individual assessment — what is right for you depends on your history, your examination and your own goals.
Common questions
Asked before, answered here
Yes, usually over six to eighteen months. The procedure can be repeated when symptoms return.
The medial branch nerves carry sensation from the joint, not power to your limbs. Position is tested electrically first.
Costs are confirmed in writing before anything is booked. Published ranges are on the fees page.
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Ask whether this suits you
Suitability is decided after an assessment, never from a form. Tell us where you are up to and we will advise honestly.
Visit
Level 2, 48 Macquarie StreetSydney, NSW 2000Response
Enquiries are answered within one to two business days. Urgent clinical matters are triaged the same day by the practice team.