Radiofrequency Neurotomy

Radiofrequency neurotomy is a minimally invasive, image-guided procedure performed by our interventional radiologists to provide targeted relief from chronic pain caused by arthritis, degeneration, neuromas, nerve irritation or following injury or surgery.

It works by delivering controlled radiofrequency energy to the specific nerves that transmit pain signals, interrupting or modulating those signals — often with significant and lasting improvement when simpler treatments have not been enough. Most procedures need only local anaesthetic, with real-time CT or ultrasound guidance allowing precise needle placement while minimising discomfort and risk.

What It Treats

Radiofrequency neurotomy can be used for a wide range of pain conditions, including:

• Joints — hip (obturator and femoral nerve branches), knee (genicular and saphenous nerves, commonly for osteoarthritis) and shoulder (suprascapular nerve)
• Spine — cervical, thoracic and lumbar facet joint pain, and sacroiliac joint pain
• Nerve pain — neuromas (post-operative, traumatic or inflammatory), occipital headache, meralgia paraesthetica and recalcitrant plantar fasciitis
• Arm and leg pain — spinal nerve roots, the dorsal root ganglion (DRG), and stellate or sympathetic ganglia
• Abdominal pain — splanchnic or coeliac plexus
• Pelvic and groin pain — pudendal nerves, the ganglion of Impar, and ilioinguinal or iliohypogastric nerves

Every patient needs careful clinical assessment first — usually including a diagnostic nerve block to confirm the target nerve is truly the source of pain. The exact workup depends on the region, so please discuss individual cases directly with the interventional radiologist.

Thermal or Pulsed?

We offer two radiofrequency techniques at Spectrum Interventional Radiology, and the treating radiologist tailors the choice to the nerve involved, the nature of the pain and the individual patient.

Thermal neurotomy (denervation) heats the nerve to around 80–90°C, creating a controlled lesion that stops pain signal transmission. Relief typically lasts 6–24 months or longer — and because nerves regenerate over time, the procedure can simply be repeated if pain returns.

Pulsed neuromodulation delivers short bursts of energy at a much lower temperature (42–45°C), modulating the pain fibres without destroying the nerve. It is often preferred for neuropathic pain or mixed-motor nerves where preserving function matters, providing long-lasting relief through a different mechanism.

What to Expect

On the day, a small grounding pad is placed on the skin and local anaesthetic numbs the skin and deeper tissues. A thin radiofrequency needle is then guided to the target nerve under real-time CT or ultrasound, a fine probe is connected to the generator, and the planned treatment is delivered. The active part takes about 30 minutes, though you will spend longer in the department for preparation and observation.

When booking, let us know if you take blood thinners, have a current illness or infection, or have any allergies (especially to local anaesthetics) — any fasting requirements will be explained when your appointment is confirmed. You will not be able to drive afterwards, so please bring a friend or family member to take you home.

Mild discomfort at the treatment site is common and usually settles within days; simple over-the-counter pain relief is typically all that’s needed. Most patients are back at work and light activities the following day. Full pain relief often takes one to three weeks to develop as the nerve responds — and if pain returns months or years later as nerve fibres regenerate, the procedure can be repeated.

Risks, Referral & Medicare

Serious complications are rare in the hands of experienced interventional radiologists using imaging guidance. Possible risks include minor infection at the needle site (serious infection occurs in fewer than 0.1% of cases), bleeding or bruising (more likely on blood thinners), temporary numbness or tingling in the territory of the treated nerve, and — rarely, with precise imaging guidance — irritation of nearby structures. Your interventional radiologist will discuss these with you in detail.

Radiofrequency neurotomy is generally offered as a second-line treatment after a positive response to a diagnostic nerve block or steroid injection. Medicare rebates apply for GP and specialist referrals, concession card holders are bulk billed, and a private gap fee applies for other patients — please confirm current fees when booking.

For suitability assessment, review of imaging or to discuss a specific case, contact Spectrum Interventional Radiology — our team is happy to provide tailored advice on radiofrequency neurotomy or our other advanced pain interventions, such as cryoneurolysis and genicular artery embolisation.