Radiofrequency Ablation for Chronic Neck and Back Pain in San Antonio

A rhizotomy, also known as radiofrequency ablation (RFA), is a minimally invasive pain management procedure designed to reduce chronic neck or back pain by interrupting pain signals traveling through specific sensory nerves. These nerves, often called medial branch nerves, transmit pain from the facet joints of the spine to the brain.

At San Antonio Pain Consultants, rhizotomy uses controlled radiofrequency energy (heat) to create a small lesion on these targeted nerves. This process effectively disrupts their ability to send pain signals, helping reduce or eliminate chronic discomfort. The procedure does not affect motor function, meaning it does not interfere with muscle movement or strength—only the pain-transmitting nerves are targeted.

Because the nerve is not permanently destroyed but rather “deactivated,” it can regenerate over time, which is why pain relief is long-lasting but not always permanent.

Rhizotomy is considered one of the most effective treatments for facet joint arthritis-related pain in both the cervical (neck) and lumbar (lower back) spine. Facet joints can become inflamed or arthritic due to aging, wear-and-tear, injuries, or degenerative spine conditions, leading to localized pain that may worsen with twisting, bending, or prolonged standing.

At San Antonio Pain Consultants, radiofrequency ablation is often recommended after diagnostic medial branch nerve blocks confirm that the facet joints are the primary pain source. When properly selected, patients with facet joint arthritis often experience a significant reduction in chronic pain, improved mobility, and better quality of life.

This procedure is especially beneficial for patients who have not achieved lasting relief from physical therapy, medications, or steroid injections, making it a strong non-surgical option for chronic spinal pain.

The duration of pain relief after rhizotomy varies depending on the individual patient, severity of arthritis, and nerve regeneration rate, but most patients experience relief lasting between 6 months and 18 months and, in some cases, even longer.

Patients are informed that the treated nerves will eventually regrow over time, which may allow pain signals to return. However, many individuals experience extended relief well beyond a year, especially when combined with physical therapy, posture correction, and strengthening exercises that support spinal health.

If pain returns after nerve regeneration, the procedure can often be repeated safely, making it a valuable long-term management strategy for chronic facet joint pain.

In many cases, yes. Radiofrequency ablation is frequently used as part of a stepwise, conservative treatment approach designed to delay or avoid the need for major spine surgery.

Rhizotomy is considered when patients have confirmed facet joint pain without structural instability or severe nerve compression requiring surgical intervention. By significantly reducing pain and improving function, the procedure often allows patients to return to daily activities, improve mobility, and manage symptoms without surgical intervention.

However, it is important to understand that rhizotomy is not a structural correction for conditions like severe spinal stenosis or instability. Instead, it is a pain-relief strategy that can reduce the need for surgery in appropriately selected patients by providing long-term symptom control.

Good candidates for radiofrequency ablation typically include patients who experience:

● Chronic neck or low back pain lasting more than 3–6 months
● Pain that worsens with movement, twisting, or spinal extension
● Confirmed facet joint arthritis or inflammation
● Temporary relief from diagnostic medial branch nerve blocks
● Limited improvement from medications, physical therapy, or steroid injections

Before recommending rhizotomy, the clinic performs a comprehensive evaluation, including medical history review, imaging studies, and diagnostic nerve blocks. These steps are essential to ensure that the facet joints are the true source of pain and that the procedure is likely to be effective.

At San Antonio Pain Consultants, patient selection is highly individualized, ensuring that radiofrequency ablation is used only when it offers the highest likelihood of meaningful and lasting pain relief.

At San Antonio Pain Consultants, radiofrequency ablation is performed using advanced imaging guidance, such as fluoroscopy, to precisely target the medial branch nerves responsible for transmitting facet joint pain. The procedure is typically done on an outpatient basis using local anesthesia and mild sedation when needed.

The physician carefully places a specialized needle near the targeted nerve, then delivers controlled radiofrequency energy to create a small thermal lesion that interrupts pain signaling. The entire procedure is designed to be minimally invasive, precise, and well-tolerated, with most patients returning home the same day.

After treatment, patients receive detailed recovery instructions and follow-up care, including recommendations for activity modification and supportive physical therapy when appropriate. The clinic closely monitors outcomes to ensure patients experience optimal pain relief and functional improvement.

By combining accurate diagnostics, precision-guided treatment, and long-term follow-up care, our team at San Antonio Pain Consultants helps patients achieve lasting relief from facet joint pain while minimizing the need for invasive surgery or long-term opioid use. For more information, contact us or schedule an appointment online. We are located at 3903 Wiseman Blvd, Ste 117, San Antonio, TX 78251. We serve patients from San Antonio TX, Helotes TX, Alamo Ranch TX, Leon Valley TX, Shavano Park TX, Balcones Heights TX, Fair Oaks TX, Fair Oaks Ranch TX, Castroville TX, and surrounding areas.