Not all chronic back pain comes from discs. The facet joints, the small joints at the back of the spine that let it bend and twist, develop arthritis like any other joint, and they carry their pain along small branch nerves. Rhizotomy treats that pain at its wiring.
What it treats
Facet joint syndrome: chronic, aching low back or neck pain that worsens with extension or twisting, often present for years. Candidacy is usually confirmed first with a diagnostic nerve block; if numbing the branch nerve stops the pain, that nerve is the culprit.
How it works
Through a tiny incision, an endoscope reaches the medial branch nerve serving the painful joint. Unlike needle-based radiofrequency ablation done through the skin, the endoscopic approach lets the surgeon see the nerve directly and treat it precisely with gentle heat. The joint, the disc, and the spine's motion are untouched.
Recovery
Outpatient, usually under local anesthesia. Most patients resume normal activity within days. Because the treatment targets a nerve rather than bone, there is no structural healing to wait for.
Who it's for, and who it isn't
Best for patients whose diagnostic block confirmed facet-driven pain. It does not treat leg pain from a pinched nerve root or claudication from stenosis. Branch nerves can regenerate over time, so relief may not be permanent, and duration varies from patient to patient. Ask your physician what to expect for your specific diagnosis.