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Medial Branch Nerve Block vs Rhizotomy: Which Is the Best Solution for Your Chronic Back Pain?

Chronic back pain affects millions of people in the United States. Interventional pain management techniques like a medial branch nerve block or facet joint rhizotomy can eliminate pain and its effects on your quality of life.

Dr. John S. Michels is an award-winning pain management specialist with a thriving practice in the Dallas-Fort Worth metroplex. Committed to providing services tailored to your needs, he may recommend minimally invasive treatments like nerve blocks and rhizotomy for effective pain relief.

Read what Dr. Michels and his team say about the differences between these in-office procedures and why either may be a good choice for relieving back pain.

What is a medial branch nerve block?

We use a medial branch nerve block to diagnose and treat pain arising from the facet joints in the spine. These small joints between the vertebrae are responsible for stabilizing the spine and allowing movement, such as twisting and bending.

Medial nerves surrounding the facet joints carry pain signals to the brain. Chronic pain is often the result when arthritis and other conditions damage the facet joints.

During a medial branch nerve block, Dr. Michels injects a local anesthetic, often combined with a corticosteroid, to reduce inflammation near the medial branch nerves surrounding the targeted joint(s). This temporarily blocks pain signals to the brain, typically offering relief for several weeks to a couple of months.

The block is also effective in pinpointing the area of pain. If the injection is successful, but your pain returns, Dr. Michels may recommend a longer-term solution like rhizotomy.

What is a rhizotomy?

A rhizotomy, also known as radiofrequency (RF) nerve ablation or neurotomy, is another in-office procedure Dr. Michels may recommend for chronic pain, particularly pain arising from the spine’s facet joints or sacroiliac joints.

During an RF rhizotomy, Dr. Michels inserts a small hollow needle into the targeted treatment area. An electrode at the tip of the needle transmits radiofrequency energy to the nerve, which generates just enough heat to create a lesion on the nerve.

This action disrupts the nerve’s ability to transmit pain signals to the brain, providing long-term relief that may last a year or more.  

What are the advantages of rhizotomy versus nerve block?

Dr. Michels bases treatment strategies on your evaluation results, but both procedures offer benefits. For instance, a nerve block may offer the relief necessary to participate fully in physical therapy and other remedies for back and neck pain.

Additionally, a medial branch nerve block is a highly effective diagnostic tool. The complexity of the spine, with numerous nerves, bones, and other structures sharing a relatively small space, can make it challenging to identify the exact location of your pain. 

A successful nerve block reinforces the initial diagnosis.

Otherwise, the primary advantage of a facet joint rhizotomy compared to a nerve block is its long-lasting pain relief. Dr. Michels uses advanced imaging techniques during the procedure to ensure accurate needle placement, making it a safe and effective treatment.

Pain relief is nearly immediate, risks are minimal compared to more invasive treatment options, and patients typically experience little, if any, discomfort during the procedure.

Conditions that respond well to facet joint rhizotomy include back pain and neck pain related to herniated discs, spinal stenosis, osteoarthritis, and other degenerative changes.

Don’t struggle with unnecessary pain. Schedule an evaluation with Dr. Michels today by calling our office or requesting an appointment online.

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