5 Signs It’s Time to Consider Rhizotomy for Your Chronic Pain

Chronic pain can drain your energy, disrupt your sleep, sour your mood, limit your mobility, and render you inactive. When it hasn’t improved with initial conservative care strategies — but you’re not ready for surgery — it’s time to try a more targeted pain relief procedure.  

Board-certified pain management specialist Okezie N. Okezie, MD, FAAPMR, and our team at Interventional Sports and Pain Management Associates can help. 

Dr. Okezie discusses the ins and outs of rhizotomy, including how it works to deliver lasting pain relief without surgery, and five signs that indicate it may be the next best step in your pain management plan.  

How rhizotomy alleviates pain 

Rhizotomy uses radiofrequency energy to target an aggravated or overactive nerve, halt its ongoing pain signals, and deliver long-lasting relief. Also called radiofrequency neurotomy or thermal rhizotomy, this minimally invasive procedure is designed to treat persistent pain conditions that are rooted in a specific problematic nerve. 

The procedure begins with fluoroscopy (live X-ray) guidance, which allows Dr. Okezie to visualize the irritated nerve. Once the treatment area has been desensitized with a local anesthetic, Dr. Okezie briefly stimulates the targeted nerve to ensure it’s the right one.

Then, he inserts the specialized rhizotomy needle near the base of the nerve. The tip of the needle emits thermal energy directly into its root, causing irreversible damage that stops its pain signals with near-immediate effect.

When to consider a rhizotomy

A rhizotomy could be the right next step for you if specific spinal nerves trigger your chronic pain and haven’t responded effectively to more conservative treatments. Dr. Okezie may recommend the procedure for you if:

1. Your pain originates from specific spinal nerves

A rhizotomy procedure provides long-term relief for pain signals stemming from a spinal nerve that’s being aggravated by a chronic problem with a nearby facet joint. Whether the joint is affected by arthritis, injury, inflammation, or degeneration, this nerve pain may manifest as:

• Long-term back or neck pain
• Radiating leg pain (sciatica)
• Radiculopathy (pinched nerve)

A rhizotomy can also deliver long-term relief for chronic nerve pain related to sacroiliac (SI) joint dysfunction. Located at the base of the spine, problems with the SI joint rank among the top causes of persistent lower back pain.

2. Conservative care hasn’t delivered sustained relief

You’ve tried it all — from rest, activity modification, OTC pain relievers, physical therapy (PT), and massage to better weight control, improved posture, and stress management — but your chronic back, neck, or radiating leg pain persists. 

A rhizotomy is considered when PT, pain medication, steroid injections, nerve blocks, and other non-surgical treatments haven’t provided adequate or lasting pain relief after months of trying. 

3. You’ve had a successful diagnostic nerve block

One of the strongest indicators for a rhizotomy is attaining significant relief after a diagnostic nerve block, even if it’s only for a short time. This highly targeted, image-guided injection helps confirm which nerve is causing your pain.  

In fact, if you have chronic spine-related pain that hasn’t improved with conservative care, a diagnostic nerve block is needed before Dr. Okezie can recommend a rhizotomy. If this test can conclusively pinpoint the source of your pain by providing temporary relief, you’re likely to experience longer-lasting relief from a rhizotomy.

4. Your pain significantly affects your quality of life

If your chronic pain condition limits your mobility, makes daily tasks harder, disrupts your sleep, leaves you feeling depressed, and stops you from being active, a rhizotomy can be a life-changing solution. 

By disabling the problematic nerve and muting its agitated signals, a rhizotomy can ease pain sensations enough to restore pain-free physical function — allowing you to make real progress in PT and reduce (or eliminate) your reliance on pain medication. 

5. You’re not ready to consider surgical interventions

Surgery is a last resort for chronic pain that continues to persist beyond all conservative care measures, including minimally invasive nerve blocks and rhizotomy procedures. 

When spine surgery isn’t yet on the table, a rhizotomy offers a way to achieve long-term relief without the risks and lengthy recovery time associated with a more extensive and invasive procedure, such as spinal fusion or a laminectomy.

Pain relief in the Houston area

​​Conventional care hasn’t resolved your chronic pain problem — could a rhizotomy be the next best step for you? To find out, schedule an appointment at your nearest Interventional Sports and Pain Management Associates office in Humble or Baytown, Texas, today.