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Inova Comprehensive Pain Centers

Back or neck pain may be due to pain coming from the facet joints in your spine. If so, medial branch nerve blocks and radiofrequency ablation of the medial branch nerves may be an option to help relieve your pain. The medial branch nerve block is a diagnostic procedure to assess whether the radiofrequency ablation of the medial branch nerve has a chance to provide longer lasting pain relief.

What are medial branch nerves?

Each vertebra in your spine has facets (flat surfaces). They touch where the vertebrae fit together. This forms a facet joint. Each facet joint has at least two medial branch nerves. They are part of the nerve pathway to and from each facet joint. A facet joint in your back or neck can become inflamed (swollen and irritated). Pain messages may then travel along the nerve pathway from the facet joint to your brain.

Medial branch nerves in each facet joint send and carry messages about back or neck pain.

How does radiofrequency ablation work?

Destroying a few of your medial branch nerves can keep certain pain messages from reaching your brain. This can help bring you relief. The relief typically lasts for 6 to 12 months but can last years.

Possible risks and complications are rare, but can include:

  • Infection
  • Increased pain, numbness or weakness
  • Nerve damage
  • Bleeding
  • Failure to relieve pain

Getting ready

Before treatment, tell your healthcare provider what medicines you take. This includes prescription and over-the-counter medicines. It includes aspirin and any vitamins, herbs and other supplements. Ask your healthcare provider if you should stop taking any medicines before treatment, especially blood thinners. These procedures are typically performed with local anesthesia and do not require sedation. However, if you are receiving sedation, follow your doctor’s directions for not eating or drinking before treatment.

Tell your healthcare provider:

  • If you are pregnant or could be pregnant
  • If you are allergic to any medicines, especially iodine or iodine contrast
  • If you have had any recent illness
  • If you have other recent changes in your health

You will lie on an exam table. You will most likely on your stomach, but it depends on where the nerve is that needs to be treated. During the procedure:

  • Your healthcare provider will clean the skin over the treatment site. He or she will then numb it with local anesthesia.
  • Your provider uses X-ray imaging (fluoroscopy) to help see your spine. The X-rays help guide the treatment. Your provider may inject a contrast “dye” into the affected area. This is to help get a better image. If you are allergic to iodine or have ever had a reaction to a dye, tell your healthcare provider.
  • Your healthcare provider typically uses heat via radiofrequency wave energy to destroy part of the nerves that transmit the pain signals from the facet joint.

You can likely go home about 30 minutes after the procedure. It is helpful to have a family member or friend drive you. The treated spot may be swollen and may feel more sore than usual. This is normal. This may last for a day or so. It will typically take 10 to 14 days before you feel relief from your symptoms.

Call your healthcare provider if you have:

  • Fever of 100.4°F or higher, or as advised by your healthcare provider
  • Chills
  • Redness or fluid leaking from the treatment area
  • Severe low back pain
  • New onset numbness or weakness