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Rhizotomy is a minimally invasive procedure used to relieve chronic nerve-related pain by targeting and disrupting specific pain-carrying nerve fibres. It is often recommended for patients with conditions such as trigeminal neuralgia, facet joint pain, sciatica, or spasticity that do not respond well to medications or physical therapy.

The procedure works by interrupting the nerve's ability to send pain signals to the brain, providing lasting relief and reducing dependence on painkillers. Rhizotomy can be performed using various techniques, including radiofrequency ablation, where heat is used to destroy the nerve, or chemical methods involving targeted injections. In some cases, especially for severe muscle stiffness, open surgical rhizotomy may be used.

The procedure is typically done under local or general anaesthesia, depending on the technique and patient condition, and is often completed as a same-day surgery with minimal hospital stay. It aims to improve quality of life by reducing pain and restoring function, although the results may vary based on the underlying condition and the patient’s overall health.

Rhizotomy is a procedure performed to relieve chronic nerve-related pain or muscle spasticity by disrupting pain signals travelling through specific nerve roots. It is commonly used to treat conditions such as trigeminal neuralgia, spasticity from cerebral palsy or multiple sclerosis, and facet joint pain in the spine (radiofrequency rhizotomy). The goal is to reduce or eliminate pain or involuntary muscle movements by selectively targeting the nerves causing the problem, while preserving other functions.

You should consult a specialist if you experience:

Severe, chronic nerve pain that doesn’t respond to medication
Sharp, stabbing facial pain (in trigeminal neuralgia)
Muscle tightness or spasms due to neurological disorders
Persistent back or neck pain due to facet joint inflammation
Limited quality of life despite physical therapy or injections

Rhizotomy is usually considered when conservative treatments fail and the pain source can be identified.

Preparation depends on the type of rhizotomy, but generally includes:

Neurological and physical exam
Imaging studies such as MRI, CT scan, or fluoroscopy
Diagnostic nerve blocks may be done beforehand to confirm the pain source
Review of current medications, particularly blood thinners
Fasting for 6–8 hours before the procedure (if under sedation or anaesthesia)
Discussion of risks, benefits, and expected outcomes with your doctor

Some types of rhizotomy are done as outpatient procedures with minimal downtime.

There are several types of rhizotomy, depending on the condition:

Radiofrequency Rhizotomy: A needle is guided to the nerve using imaging, and heat is applied via radiofrequency waves to destroy the pain fibres.
Chemical Rhizotomy: An alcohol or glycerol injection is used to damage the nerve fibres selectively.
Surgical Rhizotomy: A neurosurgeon cuts the problematic nerve root through a small incision, often used for spasticity in children or facial nerve pain.
Balloon Compression (in trigeminal neuralgia): A balloon compresses the nerve to disrupt pain signals.

The procedure is usually minimally invasive, often performed under local anaesthesia with sedation or general anaesthesia, depending on the type.

Rhizotomy typically takes 30 minutes to 2 hours, depending on the method used. Most patients go home the same day, except in cases of open surgical rhizotomy, which may require a short hospital stay.

While generally safe, potential risks include:

Temporary numbness or weakness
Pain recurrence over time
Infection
Bleeding
Nerve damage
Facial drooping (in facial rhizotomy)
Cerebrospinal fluid leak (in open procedures)

Risks vary depending on the location and type of rhizotomy performed.

Significant and targeted pain relief
Minimally invasive, with quick recovery in most cases
May delay or avoid more invasive surgery
Improved daily function and quality of life
Often reduces or eliminates the need for long-term medications

Many patients experience months to years of pain relief, especially in cases like trigeminal neuralgia or spinal facet joint pain.

Recovery is usually quick, especially with outpatient procedures. Patients may experience temporary soreness, numbness, or mild weakness. Light activities can typically resume in 1–2 days, while full recovery depends on the technique used. Pain relief may be immediate or gradual over a few days. Follow-up is essential to monitor outcomes and determine if repeat treatment is needed in the future.

Rhizotomy has a high success rate, with 70–90% of patients reporting pain relief or reduction in symptoms, depending on the condition treated. In trigeminal neuralgia, radiofrequency rhizotomy can provide effective relief lasting 1–5 years, though retreatment may be needed if symptoms return.