Medial Branch Blocks & Radiofrequency Ablation

What are Medial Branch Blocks & Radiofrequency Ablation?

Medial branch blocks and radiofrequency ablation are minimally invasive procedures that are used to diagnose and treat chronic neck or back pain. These procedures are recommended when

  • You have had chronic spine pain for at least 3 months

  • Conservative treatments such as physical therapy and over-the-counter pain medications have not provided adequate relief

  • Your pain is primarily in the neck or back

A medial branch block is a diagnostic test that helps your doctor confirm whether there is a specific joint that is the source of your pain. If the block successfully relieves your pain, you may be a candidate for radiofrequency ablation, which is a treatment that provides longer lasting relief.

Medial Branch Block - Diagnostic Step

During the procedure

You will likely need 2 branch block procedures on separate days to confirm your diagnosis.

  • You will lie down on the procedure table and your skin will be cleaned and numbed with a local anesthetic.

  • Using real time X-ray guidance, your doctor will place a thin needle near the small nerves that carry pain from your facet or sacroiliac joints.

  • A small amount of numbing medicine will be injected near the nerve.

This procedure typically takes 15-30 minutes and is done in the outpatient setting. You will be monitored briefly and then will be able to go home.

After the procedure

The medicine will begin working immediately after the injection. Perform activities that usually cause you pain and keep track of your pain levels for the rest of the day. This will help determine if you are a candidate for radiofrequency ablation.

  • The numbing medication is temporary and only lasts a few hours. Your usual pain will likely return by the end of the day.

  • You may have mild soreness over the injection site for the next day or two. This is normal and can be helped with some ice and over-the-counter pain relievers.

Radiofrequency Ablation - The Treatment Step

During the procedure

If you experienced pain relief from the diagnostic blocks, then you are likely a candidate for Radiofrequency Ablation.

  • You will lie down on the procedure table and your skin will be cleaned and numbed with a local anesthetic.

  • Using real time X-ray guidance, your doctor will guide a special needle with an electrode tip to the target nerve.

  • Your doctor may perform brief electric testing. You may feel some mild tingling or a muscle twitch. This confirms that the needle is in the correct position.

  • Once proper placement is confirmed, the electrode heats the nerve tissue to interrupt the pain signal.

This procedure typically takes 30-60 minutes and is done in the outpatient setting. You will be monitored briefly and then will be able to go home.

After the procedure

It may take 2-4 weeks to feel full pain relief from radiofrequency ablation as the treated nerves stop transmitting pain signals.

  • It is normal to have increased pain or soreness at the treatment site or a temporary flare in pain for 1-2 weeks after the procedure. This is part of the healing process and will resolve.

  • Your doctor may recommend over-the-counter pain relievers to manage post-procedure soreness.

  • Avoid strenuous activity or heavy lifting for several days after the procedure.

Pain relief from radiofrequency ablation can vary, but many patients experience signficant improvement lasting 6 months to over a year. The nerves can regrow, and the procedure can be repeated if needed.

When to call your doctor

Contact your doctor if you experience any of the following after the procedure

  • Fever or chills

  • Severe or worsening pain

  • New weakness or numbness in your arms or legs

  • Difficulty with bowel or bladder control

  • Redness, swelling, or drainage at the injection site

Frequently Asked Questions

  • The medial branch block is a procedure to make sure where exactly your pain is coming from. Once it is confirmed, the radiofrequency ablation more permanently quiets the pain signal coming from that area.

  • Some people notice relief in a few days, for others it take a few weeks. Continuing physical therapy and staying active can help patients get the most benefit.

  • Yes, if you experience soreness after the medial branch block of the radiofrequency ablation, taking over the counter pain relievers as directed can help.

  • After a medial branch block, it is important to perform any movements or activities that usually cause pain, and note how you feel when you do them, because this will help determine if you are a candidate for ablation.

  • Because nerves regenerate, radiofrequency ablation can be repeated if necessary. If the first procedure helped with pain, repeat procedures are often successful again.

  • A radiofrequency ablation generally takes around 20-30 minutes, but can vary based on how many joints need to be treated.