Lumbar Medial Branch Block & Radiofrequency Ablation (RFA)
(Image-Guided Procedure for Chronic Lower Back Pain Relief)
Overview
Lumbar medial branch blocks (MBB) and radiofrequency ablation (RFA) are a diagnostic and therapeutic procedure used to treat lower back pain that originates from the facet joints. These joints may become painful due to arthritis, repetitive motion, trauma, or degeneration.
This treatment is commonly recommended for patients with:
- Chronic low back pain
- Lumbar facet syndrome
- Lumbar spondylosis or low back arthritis
- Low back pain after motor vehicle collisions or repetitive strain injuries
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 with minor or major consequences
- Unintended spinal or 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: We ask that you 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 routine medications unless directed otherwise.
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Blood thinners, Aspirin, NSAIDs, 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 cervical epidural steroid injections 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, or worsening pain.
- Attend follow-up as scheduled.
Schedule a Consultation
If you're experiencing chronic lower back pain and seeking long-term relief, medial branch blocks and RFA may be the right option. Contact Restore Spine and Pain today to learn more and schedule your evaluation.