The procedure is performed in an operating room or procedure suite. With the patient in a prone position (on your stomach) and under local anesthesia (skin is frozen with numbing medication) and fluoroscopic (live x-ray) guidance, a radio-frequency needle is advanced to the base of the spinal bone that the nerve runs along. The needle is placed along the course of the appropriate nerve (medial branch of the dorsal ramus). The needle is heated to 80 degrees C for 90 seconds. At least 2 branches for each joint are treated in this same manner. Each branch may be heated 2-4 times to achieve a full clinical effect.