FACT SHEETS
Radiofrequency Neurotomy (RFN)
Radiofrequency neurotomy is a therapeutic procedure for pain originating from facet joints in the spine. The procedure involves using radiofrequency energy to create a heat lesion on the medial branch nerves that supply sensation to the facet joints, interrupting pain signals from these joints to the brain.
If the patient has previously experienced significant pain relief from diagnostic medial branch blocks, this suggests they are good candidates for RFN. This procedure is not diagnostic but purely therapeutic, based on prior successful diagnostic blocks.
This procedure targets the specific nerves that transmit pain signals from the facet joints, providing longer-lasting relief than temporary nerve blocks. RFN does not destroy the nerve permanently but interrupts its function for an extended period.
Should an RFN procedure provide significant pain relief, the benefits typically last between 9-14 months as the nerve gradually regenerates. Repeated procedures can be performed when pain returns, with many patients experiencing similar or better relief with subsequent treatments. Patients often incorporate exercise programs and improved body mechanics during their pain-free period to maximize long-term outcomes.
THE DIAGNOSIS FOR RADIOFREQUENCY NEUROTOMY (RFN) TREATMENT
Facet joint pain commonly manifests as axial spine pain (neck, mid-back, or low back) with or without referred pain patterns. These pain patterns rarely follow a dermatomal distribution and are typically aggravated by extension or rotation of the spine.
To confirm that facet joints are the source of pain, diagnostic medial branch blocks must be performed prior to considering RFN. Successful diagnostic blocks are a prerequisite for RFN—typically defined as at least 80% pain reduction during the effective period of the anesthetic.
Research indicates that dual diagnostic blocks (performing the procedure twice with different types of anesthetic) provide the highest level of diagnostic specificity. This careful selection process helps ensure that patients receiving RFN are those most likely to benefit from the procedure.
For patients with confirmed facet joint pain, RFN offers a longer-term solution than repeated injections, with studies showing that properly selected patients can experience 12+ months of significant pain reduction after a successful procedure.
PROCEDURE PROTOCOL
The primary purpose of RFN is to provide extended pain relief by temporarily deactivating the nerves that transmit pain signals from the facet joints. Following the procedure, implementing a consistent pain measurement method is essential to track outcomes. The Visual Analog Scale (VAS) is commonly used, rating pain from 0 to 10.
Patients should continue their regular medication schedule prior to the procedure, except for blood thinners which may need to be temporarily discontinued (only after consultation with your physician). Patients should record their baseline pain levels before the procedure for comparison afterward.
THE PROCEDURE
RFN requires inserting specialized radiofrequency needles through the skin under fluoroscopic (X-ray) guidance. The needles are carefully positioned parallel to the target nerves to ensure optimal lesioning. Once correctly placed, sensory and motor testing is performed to confirm proper positioning and minimize risk to non-target tissues.
The actual lesioning process involves heating the needle tip to 80-90°C for 60-90 seconds at each target location. Multiple lesions are typically created to ensure adequate coverage of the nerve.
It's normal to feel anxious about the procedure. However, you can be reassured that RFN is performed routinely, involves minimal discomfort due to local anesthetic use, and typically takes 30-60 minutes to complete depending on the number of levels treated. Post-procedure soreness at the treatment sites is common for 1-2 weeks but typically resolves as the therapeutic benefits become apparent.