Rhizotomy in West Orange, NJ

At our West Orange, NJ location, Gerling Spine Care and Research Institute performs rhizotomy as a minimally invasive procedure that disrupts the nerve signals responsible for chronic facet joint pain, offering relief that lasts significantly longer than conventional injections can provide.

Rhizotomy Delivers the Lasting Relief That Injections Alone Can’t

Medial branch blocks and facet joint injections serve an important role. They can confirm the facet joints as the source of chronic spinal pain and provide real symptomatic relief. But that relief has a built-in ceiling: the medication wears off, and the pain returns. Rhizotomy takes the next step, using precisely delivered radiofrequency energy to disrupt the nerve signal at its origin rather than temporarily quieting it with medication.

For patients at our West Orange location who have had positive responses to diagnostic injections but found the benefit too short-lived to be satisfactory, rhizotomy is the clinically appropriate progression and a core part of the structured pathway our team uses to manage facet-mediated spinal pain.

Contact our West Orange office today to find out whether rhizotomy is the right next step for your condition.

What Is Rhizotomy?

Rhizotomy, also referred to as radiofrequency ablation (RFA), is a minimally invasive outpatient procedure that uses radiofrequency energy to heat and disrupt the medial branch nerves responsible for transmitting pain signals from the facet joints to the brain. Once disrupted, those nerves can no longer carry that signal, typically producing relief that lasts between nine months and two years.

How Rhizotomy Differs From Injections

Injections manage pain by delivering medication that reduces inflammation or temporarily blocks the nerve signal. The benefit is real, but it is limited by how long the medication stays active. Rhizotomy works through a different mechanism entirely. It does not rely on medication wearing off or being replenished, but physically disrupts the nerve responsible for transmitting the pain, producing a more durable result. For patients whose diagnostic blocks have confirmed the facet joints as the source but whose relief has proven too brief, that durability is precisely what rhizotomy offers.

The Role of Prior Diagnostic Blocks

Rhizotomy is not performed without first establishing, through medial branch block injections, that the facet joints are genuinely the primary source of a patient's pain. Most clinical protocols require two separate positive block responses before rhizotomy is recommended, a standard that ensures the procedure is applied only where the diagnostic evidence clearly supports it. At our West Orange location, that diagnostic requirement is not a bureaucratic step; it is the foundation on which the procedure's effectiveness depends.

How Rhizotomy Works

The procedure is performed on an outpatient basis under local anesthesia with mild sedation for comfort. The patient lies face down while the treatment area is cleaned and numbed. Using fluoroscopic guidance, a specialized needle is positioned precisely alongside the targeted medial branch nerves.

A small electrical current is applied first to confirm correct needle placement, typically producing a brief muscle twitch or mild sensation. Once placement is confirmed, local anesthetic is administered, and radiofrequency energy is delivered through the needle tip, generating controlled heat that disrupts the nerve's ability to transmit pain signals. The full procedure typically takes less than an hour, and most patients are home the same day.

Dr. Gerling performing a neurological reflex test on a patient

Conditions Treated With Rhizotomy

Rhizotomy is most appropriate for chronic spinal pain confirmed through prior diagnostic injections as originating from the facet joints. It is used for patients with:

Facet joint arthropathy or osteoarthritis of the cervical, thoracic, or lumbar spine
Facet joint syndrome producing chronic axial neck or back pain
Degenerative spondylosis with significant facet joint involvement
Chronic spinal pain following whiplash or injury with confirmed facet contribution
Sacroiliac joint pain in select cases where the medial branch nerves are involved

Rhizotomy is not appropriate for pain primarily driven by disc herniation, nerve root compression, or other non-facet pathology.

Are You a Candidate for Rhizotomy in West Orange?

The strongest indicator of candidacy is a significant and reproducible reduction in pain following two separate medial branch block injections. Beyond that, suitable candidates have chronic axial spinal pain lasting three months or more, have not achieved lasting relief from conservative care or therapeutic injections, and are in acceptable overall health for an outpatient procedure.

Our West Orange team will review your full clinical and diagnostic injection history before making any recommendations. Rhizotomy is not suggested without the diagnostic foundation that gives the procedure its best chance of delivering meaningful, lasting relief.

We’re here to help you move forward.

What to Expect From Rhizotomy in West Orange

Rhizotomy is one of the most efficient procedures our practice offers, with a straightforward recovery and a fast return to normal activity for most patients.

Before Your Procedure

Your consultation will cover your diagnostic injection history, imaging, and symptom pattern in detail. Our West Orange team will confirm your candidacy, explain the radiofrequency mechanism clearly, and walk through realistic expectations around the duration of relief and the possibility of repeat treatment in the future before any decision is finalized.

The Day of Your Procedure

The procedure is performed under local anesthesia with mild sedation. You will need a driver to take you home afterward. Most patients experience mild pressure during the procedure and report minimal pain. Some temporary soreness or bruising at the treatment site is normal in the days that follow and resolves without any specific intervention.

Recovery After Your Procedure

Most patients return to normal activities within 24 to 48 hours. Some soreness around the treatment site is expected in the early recovery period. Pain relief typically begins within a few days and reaches its full effect within two to four weeks. Relief from rhizotomy generally lasts between nine months and two years. Because the medial branch nerves can regenerate over time, the procedure can be repeated when pain eventually returns, typically with comparable results.

Why Choose Gerling Spine Care and Research Institute?

The outcome of rhizotomy is closely tied to the quality of the diagnostic process that comes before it. Proceeding without first confirming the facet joints as the genuine pain source through properly conducted medial branch blocks reduces the likelihood of a meaningful result and ultimately does not serve the patient well. At Gerling Spine Care and Research Institute, we follow established clinical protocols with precision, and our full surgical and interventional range means we are equipped to manage a patient's condition at every level of complexity, wherever the diagnostic pathway leads.

Rhizotomy in West Orange Frequently Asked Questions

How long does relief from rhizotomy typically last?

Most patients experience relief lasting between nine months and two years. The variation depends on the individual, the degree of nerve disruption achieved, and how quickly the medial branch nerves regenerate over time. When pain eventually returns, the procedure can generally be repeated with comparable results.

Is rhizotomy the same thing as radiofrequency ablation?

Yes. The two terms describe the same procedure. Rhizotomy refers broadly to any procedure that disrupts a nerve, while radiofrequency ablation specifies the mechanism: the use of heat energy to achieve that disruption. In the context of facet joint pain management, the terms are used interchangeably and refer to the same intervention.

Will the procedure be painful?

The treatment area is thoroughly numbed with local anesthetic before the radiofrequency energy is delivered, and mild IV sedation is available for patients who want additional comfort. Most patients report feeling mild pressure or a brief warm sensation at most. Significant pain during the procedure is uncommon.

What if rhizotomy does not provide the relief I expected?

Incomplete relief following rhizotomy typically suggests that additional pain generators beyond the facet joints are contributing to the patient's symptoms. Our West Orange team will reassess the clinical picture thoroughly and explore alternative diagnoses and treatment strategies. In select cases where conventional radiofrequency ablation has underperformed, endoscopic rhizotomy can be a more targeted alternative.

Can the procedure address multiple spinal levels at once?

Yes. When diagnostic blocks have confirmed facet involvement at multiple levels, rhizotomy can treat all of them in a single session. This is both clinically appropriate and practical for the patient, avoiding the need for multiple separate procedures when the diagnostic evidence supports treating several levels together.