Center for Pain Management

Rhizotomy
(Lumbar Radiofrequency Neurotomy)

Modern physicians and medical researchers began experimenting with cutting or altering nerve tissue to stop pain about 100 years ago. They found that the results were not always good and most of the time the pain came back within six months.

After this, beginning in the 1950’s and 1960’s, a lot of research went into learning more about pain. It was learned that nerves do not just send pain signals, like a telephone signal over a wire, but that they process signals like a computer chip. This happens in the nerve endings out in the skin, ligaments, joints and internal organs, and again further in inside the spinal cord, and finally at many places in the lower and higher brain. So just cutting the wires any old place does not work.

During these same decades, more and more research was done on using electromagnetic energy in the treatment of medical conditions. This led to things like nerve stimulation for pain and cardiac pacemakers and defibrillators for heart disease. Other forms of electrically generated energy include lasers and electrocautery for surgery.

Researchers in the United Kingdom, the Netherlands (Holland), Australia and the United States began working on radiofrequency energy to treat pain and other conditions in the 1970’s. It was discovered that nerves could be ablated (cooked at a low temperature) without the side effects or dangers of surgical cutting. This could be done for some types of pain, but not all.

Since then, study after study has shown that properly performed Radiofrequency Ablation (RF or RFA) is highly effective in treating certain types of pain. It also is used now by cardiologists to treat some heart problems and is being used in some types of orthopedic surgery.

Our Dr. Fitzgerald has had the good fortune to study with the physicians in the Netherlands, in the 1990’s, and to learn RFA techniques from the pioneers who developed it. He has been using this technique on thousands of patients since then and has trained many physicians now using the technique.

The best application for RF is to treat spinal pain: pain arising from or near the spine caused by arthritis or trauma to the spine. In the upper neck (cervical spine) this type of pain is felt as neck stiffness, headache in the back of the head, around the ear or temples and radiating to the forehead, jaw or behind the eyes—it can trigger migraine-type headaches. In the middle and lower neck it can be felt as neck pain, shoulder pain, heaviness or aching in the arms or around the shoulder blades and upper back. In the middle and lower back, pain can run along the spine, but often radiates along the rib cage, into the hip or groin, or down into the thighs. Very often, this pain is worse with twisting or turning, looking up or reaching up, standing for a long time or bending and straightening.

Once the diagnosis is confirmed, a simple outpatient procedure is performed under sedation, treating two or three segments of the spine at a time; results are often seen immediately although usually this take a few weeks.

When conservative measures like physical therapy, medications, mobilization of the spine and so on do not work, then RFA can provide safe and highly effective long-term improvement in select patients with spinal pain.

Read more on this topic:

• Is Radiofrequency Rhizotomy the Answer for Neck Pain?

• What to Do for Scar Tissue in My Back?