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Medial Branch Neurotomy: Your Experience

Back or neck pain may be due to problems with certain nerves near your spine. If so, a medial branch neurotomy can help relieve your pain. The treatment uses heat, cold, radiofrequency, or chemicals to destroy the nerves near a problem joint. This keeps some pain messages from traveling to your brain, and helps relieve your symptoms.

The treatment is done in a hospital or outpatient department. Your healthcare provider will ask you to sign a consent form. He or she will examine you and may give you an IV (intravenous) line for fluids and medicines.

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Getting ready for your treatment

  • Ask your healthcare provider whether you should stop taking any medicines before treatment.

  • Tell your provider if you are pregnant or allergic to any medicines.

  • You may be asked to stop eating or drinking for several hours before you check in for your treatment.

During the procedure

You will lie on an exam table, most likely on your stomach depending on where the problem joint is.

  • Your healthcare provider will clean the skin over the treatment site and then numb it with medicine.

  • Your provider uses X-ray imaging (fluoroscopy) to help see your spine and guide the treatment. Your provider may inject a contrast dye into the affected region to help get a better image. If you are allergic to iodine or had a reaction to a dye, tell your healthcare provider.

  • Your healthcare provider uses heat, cold, or chemicals to destroy part of the nerve near the inflamed facet joint. Nearby nerves may also be treated.

After the procedure

Most often, you can go home shortly after the procedure, generally in about an hour. Have an adult friend or relative drive you. The treated spot may be swollen and may feel more sore than usual. This is normal and may last for a day or so. It will be a few days before you feel relief from your symptoms. Your provider may prescribe pain medicines for you during that time. Ask him or her when it’s OK for you to go back to work.

Call your healthcare provider if you have a fever over 100.4°F (38°C), chills, or redness or drainage at the treatment site.


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