Chronic pain can be debilitating, affecting every aspect of a person’s life—from their ability to work to their emotional well-being. For many patients, traditional treatments such as medication, physical therapy, or injections provide some relief, but not enough to restore function or quality of life. In these cases, interventional procedures like a rhizotomy may be considered.
Pain management specialist Jordan Sudberg has extensive experience helping patients evaluate and pursue advanced treatments for chronic pain. In this post, Sudberg explains what a rhizotomy is, how it works, when it becomes a necessary option, and what patients should expect from the procedure.
Understanding Rhizotomy: What Is It?
A rhizotomy is a minimally invasive surgical procedure aimed at interrupting nerve signals that cause pain. The term “rhizotomy” comes from the Greek word “rhiza,” meaning root, referring to the nerve roots that carry pain signals to the brain.
There are different types of rhizotomy, including:
- Radiofrequency rhizotomy: Using heat generated by radio waves to selectively destroy nerve fibers
- Chemical rhizotomy: Injecting chemicals such as phenol or alcohol to chemically disrupt nerve function
- Cryo-rhizotomy: Freezing nerve tissue to block pain signals temporarily
The most common is radiofrequency rhizotomy, which targets specific nerves responsible for chronic pain conditions, especially in the spine.
How Does a Rhizotomy Work?
The goal of a rhizotomy is to reduce or eliminate pain by disrupting nerve pathways transmitting pain signals. The procedure involves:
- Identifying the target nerve roots using imaging guidance such as fluoroscopy or CT scan
- Administering local anesthesia to numb the area
- Inserting a thin needle electrode near the nerve root
- Applying radiofrequency energy to heat and selectively damage the nerve fibers
This “deactivation” of the nerve prevents it from sending pain signals to the brain, resulting in significant pain relief for many patients.
Jordan Sudberg explains, “A rhizotomy is not a cure for the underlying condition but a way to manage symptoms when other treatments have failed.”
When Is a Rhizotomy Necessary?
Jordan Sudberg emphasizes that rhizotomy is reserved for patients with specific chronic pain conditions who meet certain criteria. It is typically considered only after less invasive options have been exhausted.
Common indications include:
1. Chronic Facet Joint Pain
Facet joints in the spine can become inflamed or arthritic, causing localized and referred pain. When facet joint injections or nerve blocks provide temporary relief, a radiofrequency rhizotomy may be recommended for longer-lasting results.
Sudberg notes, “Patients with persistent neck or lower back pain stemming from facet joints are prime candidates, especially if diagnostic blocks confirm the source.”
2. Sacroiliac Joint Dysfunction
The sacroiliac (SI) joints connect the lower spine to the pelvis and can cause chronic pain. Similar to facet joint pain, patients with SI joint dysfunction who respond to diagnostic nerve blocks might benefit from rhizotomy.
3. Trigeminal Neuralgia
This condition involves severe facial pain due to irritation of the trigeminal nerve. Rhizotomy can be used to selectively damage nerve fibers to relieve pain in refractory cases.
4. Spasticity and Muscle Control
In cases of severe spasticity, such as from cerebral palsy or multiple sclerosis, selective dorsal rhizotomy may be used to cut nerve rootlets causing muscle tightness, improving mobility and comfort.
Criteria for Considering Rhizotomy
Jordan Sudberg stresses the importance of careful patient selection to maximize benefits and minimize risks:
- Confirmed diagnosis of nerve-mediated pain through clinical examination and diagnostic blocks
- Failure of conservative treatments including medications, physical therapy, and injections
- Pain significantly impacting quality of life and daily functioning
- No contraindications such as infection, bleeding disorders, or certain neurological conditions
“If a patient does not respond to diagnostic nerve blocks or the pain is diffuse and poorly localized, rhizotomy may not be appropriate,” Sudberg cautions.
What to Expect Before, During, and After a Rhizotomy
Before the Procedure
Patients typically undergo:
- Comprehensive evaluation including imaging (MRI, CT)
- Diagnostic nerve blocks to confirm the pain source
- Review of medical history and medications
Jordan Sudberg emphasizes, “Preparation and patient education are key to reducing anxiety and ensuring realistic expectations.”
During the Procedure
Rhizotomy is usually performed on an outpatient basis with sedation or local anesthesia. The procedure takes 30–60 minutes, during which the physician carefully targets the nerve roots with imaging guidance.
After the Procedure
Patients may experience soreness at the injection site for a few days. Pain relief typically begins within 1–2 weeks and can last from 6 months to 2 years, depending on the nerve regeneration.
Sudberg advises, “Follow-up care is crucial. Patients should monitor symptoms and maintain physical therapy to support recovery.”
Risks and Considerations
Like any medical procedure, rhizotomy carries some risks, though serious complications are rare when performed by experienced specialists like Jordan Sudberg.
Potential risks include:
- Temporary numbness or weakness
- Infection at the injection site
- Nerve damage causing increased pain or loss of function
- Recurrence of pain as nerves regenerate
“Patients should have a clear understanding of benefits versus risks before proceeding,” Sudberg emphasizes.
How Jordan Sudberg Integrates Rhizotomy into a Comprehensive Pain Management Plan
Jordan Sudberg views rhizotomy as one component of a holistic, multidisciplinary approach. He often combines the procedure with:
- Physical rehabilitation to restore mobility
- Psychological support to address chronic pain coping
- Medication management to reduce reliance on opioids
“Rhizotomy can provide significant relief, but it’s most effective when integrated with other therapies tailored to the individual patient,” Sudberg explains.
Is Rhizotomy Right for You?
If you suffer from chronic pain that has not responded to conservative treatments, it may be worth discussing rhizotomy as an option with a pain specialist like Jordan Sudberg.
Key questions to ask your doctor include:
- What type of rhizotomy is recommended for my condition?
- What outcomes can I realistically expect?
- What are the risks and side effects?
- How will this procedure fit into my overall treatment plan?
- What is the expected duration of pain relief?
Jordan Sudberg encourages patients to take an active role in their pain management journey. “Informed patients are empowered patients,” he says.
Final Thoughts
A rhizotomy can be a valuable tool in managing chronic pain, especially when other treatments have failed. Thanks to advances in technology and expert care from specialists like Jordan Sudberg, many patients achieve meaningful relief that improves their function and quality of life.
If you’re exploring options for chronic pain relief, consult with a qualified pain management professional to see if rhizotomy might be the right next step.