Thoracic Facet Radiofrequency Neurotomy

Thoracic facet radiofrequency neurotomy uses heat to create a lesion on the medial nerve. The lesion impairs the medial nerve’s ability to transmit signals about facet joint pain. Because the nerve is “turned off,” pain is not felt.

A thoracic selective nerve root block is an outpatient procedure. You will wear a gown for the procedure and be positioned lying face down on a table. You will receive relaxation medicine before your procedure begins. Your upper back area will be sterilized and numbed with an anesthetic medication.

Your doctor will use a live X-ray image (fluoroscopy) to carefully insert and guide a needle-like tube (cannula) to the affected medial nerve. A small wire-like electrode (radiofrequency electrode) is inserted through the cannula. To ensure the cannula is in the correct position, a very mild electrical current is delivered through the electrode to the nerve. The nerve will briefly conduct pain signals and cause a muscle twitch, confirming that the correct nerve is targeted. Next, numbing medication is delivered to the nerve in preparation for the treatment. Heat is delivered through the electrode to the nerve. The heat creates a lesion on the nerve. The heat disrupts the nerve’s ability to send signals about pain. At the end of the procedure, the cannula and electrode are removed. The process can be repeated for additional nerves that require treatment.

You will be monitored for several minutes before you can return home. You should have another person drive you home because you received sedation. You should use care while resuming your regular activities over the next several days because your back will feel sore. Your doctor may prescribe pain medication, rest, and instruct you to use heat or ice packs to ease the pain.

It usually takes three to four weeks for the treated nerves to completely die. You may experience pain until the treated nerves are dead.

Thoracic facet radiofrequency neurotomy typically results in pain relief for about 9 to 14 months, or longer. About 50% of people experience pain relief for as much as two years. Over time, the nerves will grow back (regenerate). Some people will not experience pain again. If you experience pain, the procedure may be repeated.

Nevada Advanced Pain Specialists is recognized as an industry leader in pain management. We have a state-of-the-art facility in Reno, Nevada, that allows for us to offer the highest possible level of quality care of our patients.

We are committed to providing a comprehensive and multi-disciplinary approach for each individual’s pain complaints to provide the most appropriate care. Our approach includes analysis of biomechanics, joint motion, as well as skeletal, nerve and muscle tissues. Every individual is evaluated for the root cause of their pain – not just a “quick fix” approach to only provide symptomatic relief.

Your pain will be evaluated with latest diagnostic tools and technologies used by the professionals at Nevada Advanced Pain Specialists to make accurate assessments including: EMG/Nerve testing, MRIs, x-rays, bone scans, and diagnostic pain injections.


Over 90% of our facet joint injection patients report improvement in their condition. Over 75% said their condition improved by more than 50%

Over 83% of our epidural patients report improvement in their condition. Over 75% said their condition improved by more than 50%

Overall, 83% of our patients report a better quality of life, 60% report less pain, and 62% report improvement in their function

Ready to come see one of our physicians?