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Both a facet block and a rhizotomy procedure can be used as a form of treatment for pain in the facet joints. Facet joints are connected to vertebrae and allow movement of the spine. When these joints become inflamed, they can cause significant pain that radiates throughout the spine and other parts of the body. During a facet block, both a numbing agent and an inflammatory medication is injected into the facet joints. This can provide both a diagnosis of the affected facet joints and a treatment to help reduce inflammation in the joints. A rhizotomy works by destroying the nerve that is connected to the facet joint, stopping the signals that are causing pain. At Lewis Pain Management, Dr. Jerry Lewis performs both facet block and rhizotomy procedures as a way to identify and treat back pain that may be caused by a condition in the facet joints. Contact our Frisco, TX office to learn more about both procedures.


An ideal candidate for a facet block can be any individual who is experiencing significant back pain when bending or twisting their spine. Typically, an MRI will already have been performed in order to rule out any other conditions. A rhizotomy is typically performed after a diagnostic test procedure such as a facet block or a medial branch block. Most often another form of treatment, such as a facet block, will be tested as a form of pain relief before a rhizotomy is suggested.



A facet block procedure is performed as an outpatient procedure with the patient under an IV sedation and local anesthetic. Dr. Lewis will use a fluoroscopy x-ray to help correctly position the needle before injecting the combination anesthetic and corticosteroid medication. If performed as a diagnostic procedure, patients may be asked to act out specific movements and record their pain levels in order to diagnose the origin of the pain.


A rhizotomy is an outpatient procedure and the patient is put under general anesthesia. Dr. Lewis will use the fluoroscopy to place the needle in the correct nerve. The electrode connected to the needle will then emit heat caused by radiofrequency energy. The heat cauterizes the nerve root which stops pain transmission from the nerve. Typically, there are two nerves connected to one facet, so several areas may need to be treated depending on the number of affected facet joints.


Following either procedure, Dr. Lewis will provide appropriate aftercare instructions. Patients may be monitored for some time but are typically able to return home on the same day or the next day. The length of time that the results remain effective will depend on the procedure that was performed as well as the patient and any underlying conditions. A follow-up appointment with Dr. Lewis may be necessary so that he can evaluate your treatment plan as necessary.


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A condition that affects the facet joints can debilitating pain throughout the back, neck, and shoulders. Dr. Lewis provides both diagnostic testing and treatment in order to alleviate pain and allow patients comfortable movement. To schedule a consultation, contact our Frisco, TX office today.

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*Individual results are not guaranteed and may vary from person to person. Images may contain models.

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In accordance with Texas Medical Board guidelines as of May 1, 2020 the following must be met: (I) A mask must be worn by both the patient and physician or Physician's delegate when in proximity of a patient (meaning less than a 6-foot distance between the patient and Physician or the physician's delegate); (II) All patients must follow the COVID-19 screening policy in place; (III) Before any encounter, patients must be screened for potential symptoms of COVID-19 or verified previously screened within last 20 days; and (IV) prior to care involving a medical procedure or surgery on the mucous membranes, including the respiratory tract, with a high risk of aerosol transmission, the minimum safety equipment used by a physician or physician's delegate should include N95 masks, or an equivalent protection from aerosolized particles, and face shields