Nerve Pain Relief Without the Scalpel: What to Know About Rhizotomy

Living with chronic nerve pain means making constant calculations. Will sitting through dinner with friends trigger a flare-up? Can you make it through a workday without the pain becoming unbearable? You’ve tried the standard treatment options, but the pain hasn’t improved.

Rhizotomy targets the nerves that refuse to stop firing pain signals long after any initial injury has healed. Board-certified pain management physician Mahesh Mohan, MD, and our team at Pain Specialists of Frisco use this procedure to address nerve pain at its source rather than just managing symptoms. 

We can help you understand whether rhizotomy makes sense for your particular pain condition and what kind of relief you might expect.

How rhizotomy stops nerve pain

Rhizotomy targets the nerve fibers that won’t stop sending pain signals to your brain. When nerves become damaged or irritated, they can malfunction and continue transmitting pain messages even after healing occurs. This procedure uses precise techniques to disrupt those faulty signals without requiring traditional surgery.

The damaged nerve fibers lose their ability to communicate pain signals, but other nerve functions remain intact. You keep sensation and movement while getting relief from chronic pain that hasn’t responded to conservative treatment.

Different rhizotomy techniques for different pain sources

Dr. Mohan tailors the rhizotomy approach based on where your pain originates and its cause. Each of these techniques targets nerve fibers differently:

Radiofrequency ablation

This is the most common rhizotomy technique for chronic back and neck pain. Dr. Mohan uses fluoroscopic imaging to guide a thin needle to the problematic nerve. High-intensity radio waves generate controlled heat that disrupts the nerve’s ability to transmit pain signals.

Glycerin rhizotomy

This technique treats trigeminal neuralgia — a condition that causes sudden, severe facial pain triggered by everyday activities, such as brushing your teeth, chewing, or even feeling a breeze on your face. 

Dr. Mohan injects sterile glycerin near the affected nerve root. The glycerin damages the nerve fibers responsible for transmitting pain while preserving other nerve functions.

Endoscopic rhizotomy

This approach utilizes a tiny camera called an endoscope to visualize the nerve directly. Dr. Mohan can identify which nerve fibers are causing your pain and carefully cut them. 

When rhizotomy makes sense for chronic pain

Common conditions that respond well to rhizotomy include:

• Chronic back or neck pain from damaged facet joints
• Arthritis-related pain in your spine’s facet joints
• Trigeminal neuralgia that medication hasn’t controlled
• Nerve pain that prevents you from working or enjoying activities
• Pain that’s been confirmed through diagnostic nerve blocks

Before recommending rhizotomy, Dr. Mohan often performs diagnostic nerve blocks first. These temporary blocks use a local anesthetic to numb the suspected nerve. If you experience substantial relief from the nerve block, rhizotomy will likely also help. 

Rhizotomy procedure and recovery

Rhizotomy happens in our office as an outpatient procedure, so you don’t need to stay overnight. Here’s what you can expect from start to finish:

Before the procedure

Dr. Mohan numbs the treatment area with a local anesthesia so you don’t feel pain during the procedure. Plan for your entire appointment to last an hour, though the nerve treatment itself takes just minutes.

During the procedure

Dr. Mohan uses fluoroscopic imaging — real-time X-ray guidance — to position the needle precisely at the nerve causing your pain. This imaging ensures accurate placement, allowing the treatment to target the correct nerve fibers.

Once the needle is in place, Dr. Mohan performs the specific rhizotomy technique appropriate for your condition. You might feel pressure or a brief warming sensation, but the local anesthetic prevents sharp pain.

Immediate recovery

After your procedure, you rest in our office for a short observation period before heading home. You can expect some soreness and possible bruising around the injection site for a few days. Most people return to their regular activities within a day or two.

Pain relief timeline

Pain relief doesn’t always happen immediately. Some patients notice improvement within a few days, while others experience the full benefit after a week or two, once inflammation subsides. 

The duration of relief varies from person to person. When pain eventually returns, Dr. Mohan can repeat the procedure. Many patients find that subsequent treatments provide similar relief to the first.

Moving beyond nerve pain

Rhizotomy treats the pain, but Dr. Mohan doesn’t stop there. He recommends complementary therapies that support your recovery and help prevent pain from returning. 

If you’re living with chronic nerve pain that conservative treatments haven’t helped, rhizotomy at Pain Specialists of Frisco may offer the relief you need. Call our office most convenient to you, today — in Frisco, Dallas or Fort Worth, Texas — to schedule a diagnostic evaluation or book your appointment online.