Medial branch neurotomy

Back or neck pain may be due to problems with certain nerves near your spine. If so, a medial branch neurotomy can help ease your pain. Neurotomy destroys a nerve to relieve pain or stop involuntary movements. In some cases, your healthcare provider may give you a nerve block to see how your body will respond to neurotomy. 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 ease your symptoms.

Medial branch nerves

Each vertebra in your spine has facets (flat surfaces). They touch where the vertebrae fit together. This forms a facet joint. Each facet joint has at least 2 medial branch nerves. They are part of the nerve pathway to and from each facet joint. A facet joint in your back or neck can become inflamed (swollen and irritated). Pain messages may then travel along the nerve pathway from the facet joint to your brain.

Three-quarter view of three vertebrae and disks showing spinal cord, spinal nerves, and medial branch nerves.

Blocking pain messages

Medial branch nerves in each facet joint send and carry messages about back or neck pain. Destroying a few of these nerves can keep certain pain messages from reaching your brain. This can help bring you relief. The relief typically lasts for months to years.

Risks and complications

Risks and complications are rare. But they can include:

  • Infection

  • Increased pain, numbness, or weakness

  • Nerve damage

  • Bleeding

  • No relief of pain