Cervical Medial Branch Block & Radiofrequency Ablation (RFA)

Cervical Medial Branch Block & Radiofrequency Ablation (RFA)

(Image-Guided Procedure for Chronic Neck Pain Relief)

Overview

Cervical medial branch blocks (MBB) and radiofrequency ablation (RFA) are a step-by-step diagnostic and therapeutic approach for neck pain caused by arthritic or inflamed facet joints in the cervical spine. These joints can become a source of pain due to age-related changes, trauma, or repetitive stress.

Lumbar Epidural Steroid Injection

This treatment is often recommended for patients with:

  • Chronic neck pain
  • Cervical facet syndrome
  • Cervical spondylosis or arthritis of the neck
  • Neck pain following auto or work-related injury

What are the risks and side effects?

Risks and side effects are minimal, and serious complications are rare. We take every precaution to ensure your safety. Potential risks may include but are not limited to:

  • Vasovagal response (fainting or dizziness)
  • New or increased pain
  • Infection
  • Bleeding
  • Permanent skin changes
  • Allergic or unexpected drug reaction
  • Unintended nerve injury

Ask your provider if you have any concerns. Your physician will review the risks in detail before the procedure to ensure you are fully informed.

Pre-Procedure Information

How Should I Prepare?

  • Driver Required: Please arrange for a driver to take you home after the procedure.
  • Food: You may eat a light meal 1–2 hours prior to the procedure. If sedation is planned, please follow the specific sedation protocol provided by our team.

Medications

  • Continue regular medications unless advised otherwise.
  • Blood thinners, NSAIDs, Aspirin, and supplements:
    • Inform us if you are taking any blood thinners (e.g., Eliquis, Plavix, Xarelto), NSAIDs (e.g., ibuprofen, naproxen), aspirin, or supplements with blood-thinning properties.
    • These may need to be stopped temporarily before your injection.
    • Consult your primary care physician to confirm it is safe to hold these medications.
    • Our team will guide you based on your medication list and coordinate as needed.

    Notify us if:

    • You have a fever, infection, or are feeling unwell.
    • You have started antibiotics or had changes to your medications

Sedation

Most procedures can be performed comfortably without sedation. However, if you have anxiety or difficulty lying flat, mild sedation may be offered at the discretion of the physician. Please discuss this with your provider in advance.

Special Instructions for Diabetic Patients:

Steroid injections may raise blood sugar levels for several days.

  • Please contact your primary care physician or endocrinologist prior to the procedure for management recommendations.
  • Monitor your glucose closely after the injection.
  • Report sustained elevations to your managing provider.

What if I am pregnant?

There are serious potential risks to an unborn fetus from imaging used during this procedure (e.g., X-ray/fluoroscopy). If there is any chance you may be pregnant, please notify our team immediately and postpone the injection until pregnancy is ruled out.

Procedure Information

The procedure is performed using sterile technique under real-time X-ray (fluoroscopic) guidance.

Procedure Details

Step 1 – First Medial Branch Block (Diagnostic)

  • Local anesthetic is used to numb the medial branch nerves suspected of causing pain.
  • This is a diagnostic procedure designed to confirm if the facet joints are the source of your pain.
  • This relief is only intended to last approximately 8 hours.

Step 2 – Second Medial Branch Block (Diagnostic)

  • A second diagnostic block is performed on a different day to confirm consistent pain relief.
  • If both injections provide significant temporary relief, you may be a candidate for RFA.

Step 3 – Cervical Radiofrequency Ablation (RFA)

  • A special needle delivers radiofrequency heat to disable the medial branch nerves.
  • This can provide relief that typically lasts 6–12 months or longer.

Monitoring

  • You will be monitored during and after the procedure for safety.

Post-Procedure Information

  • Relief Timeline: : Soreness from the procedure is common. Lasting relief from RFA typically begins within 2–4 weeks.
  • Activity: Rest for the remainder of the day. Resume light activities the following day and avoid heavy lifting or strenuous activity for 24–48 hours.
  • Symptom Tracking: Keep a journal of your symptoms for follow-up

Additional Instructions:

  • Contact the office for any signs of infection, fever, worsening pain or new weakness or sensory changes.
  • Attend follow-up as scheduled.

Schedule a Consultation

If you're living with chronic neck pain that may be caused by arthritic joints in the spine, medial branch blocks and RFA may help. Contact Restore Spine and Pain to schedule your evaluation.

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