Radiofrequency Ablation (Medial Branch Neurotomy)

Radiofrequency ablation, also referred to as medial branch neurotomy, is a procedure we use to ease chronic neck or back pain that comes from the small joints of the spine. It targets nerves that carry pain signals from the facet joints, which are part of your spinal joints. The treatment is minimally invasive and is done through small needles rather than open surgery. Many patients choose this option when other treatments, like medications or physical therapy, have not provided lasting relief. It can help reduce pain so you can return to daily activities with less discomfort. At Princeton Orthopaedic Associates we explain what to expect and how the procedure may fit into your care plan.

Radiofrequency Ablation (Medial Branch Neurotomy) Details

Radiofrequency ablation treats pain that comes from the facet joints of the spine. These joints connect the vertebrae and help your spine move. The nerves that supply these joints are called medial branch nerves. When these nerves send continuous pain signals, we can interrupt those signals with heat generated by radiofrequency energy. The goal is to lessen pain coming from joint wear, injury, or inflammation in the spine, which affects bones and nearby soft tissues. This procedure is usually recommended when a targeted diagnostic injection, called a medial branch block, has shown that those nerves are the source of your pain. It is not recommended if your pain comes from other causes, such as widespread nerve disease, muscle pain without joint involvement, or active infection near the spine. Your care team at Princeton Orthopaedic Associates will help determine if this is a suitable option for you.

Radiofrequency Ablation (Medial Branch Neurotomy) General Treatment Details

During the procedure you lie on an X-ray table while we use imaging to guide a thin needle to the small nerves near the spine. We test the needle position with a small electrical current to make sure the right nerve is targeted. Then radiofrequency energy heats the tissue at the needle tip to interrupt the pain signal. The whole treatment is done through a tiny skin puncture, so there is no large incision.

The tools used include fluoroscopy, which is a live X-ray, a specialized radiofrequency probe, and local anesthetic for comfort. The procedure is typically done under light sedation or local anesthesia so you stay comfortable and awake enough for feedback if needed. Because it is minimally invasive, this approach reduces tissue damage and lowers the chance of long recovery compared with open surgery.

The aim is not to repair tissues like bones or ligaments, but to reduce pain signals that come from the facet joints and nearby soft tissues. By breaking the pain signal temporarily, many patients find they can be more active and participate in rehabilitation that helps long-term function.

Radiofrequency Ablation (Medial Branch Neurotomy) Recovery Details

After the procedure you may have some soreness at the injection site for a few days. Most people can go home the same day and resume light activities within 24 to 48 hours. You should expect to limit heavy lifting, twisting, or strenuous exercise for a short time while the treated area settles.

Pain relief often begins within a week and can last many months, but varies by person. We commonly recommend doing physical therapy or a guided exercise program after recovery to strengthen the spine and improve motion. Factors that can lengthen recovery include smoking, poorly controlled medical conditions, obesity, or ongoing work that places heavy strain on the spine.

Benefits of Radiofrequency Ablation (Medial Branch Neurotomy)

Primary benefits include reduced chronic pain from facet joints and improved ability to perform daily tasks. Because the procedure is minimally invasive, it usually means less tissue damage, a shorter recovery time, and a lower risk than open spine surgery. Many patients gain months of relief that lets them take part in physical therapy and activity programs that can help long-term function.

Like all procedures, radiofrequency ablation has potential risks. These can include infection, bleeding, damage to a nearby nerve or blood vessel, stiffness, or persistent pain. In rare cases numbness or increased pain can occur. Your Princeton Orthopaedic Associates clinician will review these risks with you and answer questions based on your health history.

Radiofrequency Ablation (Medial Branch Neurotomy) Patient Guidance

General steps to prepare include arranging a ride home, wearing comfortable clothing, and following instructions about medications. You may be asked to stop certain blood thinners before the procedure. If you are given sedation, you should not drive that day. These are general points only, and you should consult your doctor for specific instructions.

During recovery you may need short work restrictions and to avoid heavy exertion. Light walking and gradual return to activity are usually encouraged. Following the post-procedure plan from Princeton Orthopaedic Associates helps you get the best result and reduce complications.

Radiofrequency Ablation (Medial Branch Neurotomy) Quick FAQ's

Will this procedure cure my back or neck pain? Radiofrequency ablation can reduce pain from facet joints but it is not a cure for all spine problems.

How long does relief last? Relief varies, often lasting months; some patients may have longer benefit and others may need repeat treatment.

Is it safe to have repeated treatments? Repeating the procedure is commonly done for returning pain, and your care team can advise whether it is appropriate for you.