Nerve Pain Relief Without the Scalpel: What to Know About Rhizotomy

No matter what the underlying cause, most cases of chronic pain share a common attribute: They persist because a damaged, irritated, or otherwise problematic nerve (or nerve bundle) keeps sending pain signals to your brain. Initial conservative care strategies for chronic pain may include: 

• Activity modification 
• OTC pain relievers 
• Physical therapy (PT) 
• Massage therapy
• Better weight control
• Refined ergonomics
• Stress management

If this standard treatment approach doesn’t lead to sustained improvement after a few weeks, Dr. Okezie N. Okezie may recommend a more targeted pain relief procedure. 

At Interventional Sports and Pain Management Associates, your pain management plan may begin with injections (i.e., nerve blocks, joint injections, trigger point therapy). Should those fail to deliver, the next best step may be a non-surgical procedure called rhizotomy.  

What is non-surgical rhizotomy? 

Rhizotomy is a chronic pain procedure that treats overactive nerve tissues — or those that continue sending pain signals despite interventions aimed at calming those fibers and stopping their signals. Rhizotomy delivers effective relief by damaging the problematic nerve so it can no longer send pain signals.

Non-surgical rhizotomy is a scalpel-free, no-incision treatment that utilizes radiofrequency energy waves to generate precision-directed heat, targeting and destroying overactive nerves without harming nearby tissues.  

Also known as thermal rhizotomy or radiofrequency ablation (RFA), this pain relief procedure is most effective for persistent pain conditions that can be attributed to specific overactive nerve fibers. 

A versatile pain relief procedure

Dr. Okezie can use RF rhizotomy to address a wide range of chronic pain conditions that haven’t improved substantially with initial conservative care measures or injection therapy. He may recommend it for:

• Long-term back or neck pain
• Radiating leg pain (sciatica)
• Arthritis-related joint pain 
• Radiculopathy (pinched nerve)
• Facial pain (trigeminal neuralgia)
• Chronic cluster headaches

Most often, Dr. Okezie uses rhizotomy to relieve spine- or joint-related pain problems. Facet rhizotomy targets nerve roots in the facet joints of the spine to disrupt pain signals caused by herniated discs, spinal stenosis, arthritis, and other degenerative conditions. 

Rhizotomy can also deliver immediate, long-lasting relief for osteoarthritis-related pain of the hips, knees, facet joints, and sacroiliac (SI) joints.

What to expect during rhizotomy

Before you undergo a rhizotomy procedure, Dr. Okezie discusses your medical history, performs a comprehensive physical exam, conducts noninvasive imaging tests (i.e., X-ray, MRI), and confirms the source of your pain with a diagnostic injection (i.e., nerve block). 

You may be asked to stop taking certain medications (i.e., anti-inflammatories, blood thinners) for a specific period leading up to the treatment. On the day of your appointment, you can expect:

Anesthetic

Rhizotomies are usually done with the aid of a local anesthetic and/or sedation, helping you feel calm, relaxed, and desensitized (numb) at the treatment site for the duration of your procedure.  

Image guidance

Dr. Okezie relies on imaging guidance, usually in the form of fluoroscopy (live X-ray), to locate the problematic nerve. He may inject a harmless substance called contrast dye through an IV to ensure your nerves show up more clearly on the live X-ray. 

Nerve testing 

Next, Dr. Okezie briefly tests the targeted nerve with electrical stimulation to ensure it’s the exact one that requires treatment.   

Nerve ablation 

Once the overactive nerve has been definitively visualized, Dr. Okezie continues using imaging guidance to place the rhizotomy needle with precision. 

Next, he delivers the RF energy to the root of the problematic nerve, damaging it beyond repair and cutting off its pain signals with near-instant effect.  

Recovery  

While the rhizotomy itself only takes a few minutes, you can expect to spend an hour or two in a recovery room as the local anesthetic and sedation wear off. 

You can return to normal activities within one to two days, but it's best to avoid strenuous activity and heavy lifting for about a week. Most patients experience rapid pain relief that lasts for several years, and sometimes indefinitely.  

Tired of living with chronic pain? 

If conventional care hasn’t helped your chronic pain, rhizotomy may be the best next step. Contact your nearest Interventional Sports and Pain Management Associates office in Humble or Baytown, Texas, to find out if you’re a candidate.