Rhizotomy vs. Nerve Blocks: What’s the Difference?

You’ve been dealing with persistent nerve-related pain for so long that you’re beginning to wonder if you’ll ever be your energized, active self again. Unfortunately, the first-step pain management strategies you’ve tried — from rest and activity modification to physical therapy (PT) and cold/heat therapy —  have only delivered temporary relief. 

You’re ready for a next-level pain relief procedure, but you’re unsure which approach is best for you. Luckily, our Interventional Sports and Pain Management Associates team can help. 

Here, board-certified pain management specialist Dr. Okezie N. Okezie explains the difference between two effective treatments for ongoing nerve pain: a therapeutic nerve block injection and a minimally invasive rhizotomy procedure. 

Alleviating pain with a therapeutic nerve block 

A nerve block, also known as a neural blockade, involves injecting a local anesthetic and an anti-inflammatory medication into a specific nerve (or nerve group) that sends persistent pain signals to the brain. 

Pain relief benefits  

A nerve block aims to deliver fast, short-term pain relief on two levels. First, its anesthetic component “blocks” the pain signals a problematic nerve emits so they can’t trigger pain sensations in your brain. And second, its anti-inflammatory element supports nerve healing, promoting longer-lasting pain relief. 

Typical applications 

A nerve block can help relieve many types of short-term (acute) and long-term (chronic) pain conditions, ranging from pain following surgery to recurrent back and neck pain. We may recommend it to alleviate persistent nerve pain stemming from:

• A slipped or herniated disc
• Radiculopathy (a pinched nerve)
• Sacroiliac (SI) joint dysfunction
• Neuropathy (nerve damage)
• Trip-and-fall car crash injuries
• Joint damage (osteoarthritis) 

A nerve block may be done to provide short-term pain relief so you can make advances with foundational pain relief treatments like physical therapy. It could also be done to help pinpoint the cause of your pain with greater precision.

Treatment details

A nerve block treatment takes 15-30 minutes. After disinfecting and numbing the injection site area, we use ultrasound or fluoroscopy (a live X-ray) guidance to direct the needle near the targeted nerve. Then, we inject the anti-inflammatory anesthetic medication. The treatment takes effect quickly and provides relief for up to weeks at a time. 

Instant pain relief with a rhizotomy procedure 

A rhizotomy is a precise, minimally invasive surgical procedure that deadens the root of a problematic nerve (or nerve group) to permanently eliminate the unrelenting pain signals and sensations they’ve been causing.

Pain relief benefits  

Rhizotomy either severs a problematic nerve root with surgical instruments or burns it with precision-injected chemicals or electrical currents. This effectively deactivates the root so it can no longer transmit signals. It delivers instant pain relief that can last several years — until the nerve eventually recovers and heals.  

Typical applications 

A rhizotomy may be recommended for a chronic pain condition that hasn’t improved (or has worsened) with conservative care and stems from a specific nerve (or nerve bundle) that’s been pinpointed with diagnostic testing, such as a previous nerve block treatment. 

A rhizotomy is essentially a “semi-permanent” nerve block that can deliver long-lasting relief for the same pain conditions that a nerve block can treat. It can also ease muscle spasms caused by nerve pain.

Treatment details

Dr. Okezie typically performs percutaneous rhizotomy, which involves injecting an ablative (i.e., damaging) chemical agent or electrical current directly at the base of a nerve that’s sending constant pain signals. It takes about an hour to complete.     

After cleaning the injection site, we administer a local anesthetic and a sedative to keep you comfortable. We insert a hollow needle near the base of the affected nerve using imaging guidance and an injection of contrast dye for optimal visualization. 

Finally, we test the nerve with electrical stimulation to ensure it’s right, then destroy the problematic nerve fibers with chemical or heat energy. 

Choosing the right pain relief treatment for you

A nerve block offers temporary relief from a persistent pain condition that might still improve with conservative care, like PT. Essentially, it’s a “front-line” treatment that can help pinpoint the exact cause of your pain while providing the short-term respite you need to make progress with other therapies — in the hope that you won’t need a more drastic solution in the future. 

A rhizotomy, on the other hand, aims to be a more permanent solution for chronic pain that hasn’t sufficiently improved with conservative pain management care and other medical interventions. Because it effectively kills a problematic nerve, it’s considered a “last resort” pain relief procedure. 

Are you ready to explore your options for next-level pain relief? Interventional Sports and Pain Management Associates is here to help. Call or click online to schedule a visit at your nearest office in Humble or Baytown, Texas, today.