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medial branch blocks and radiofrequency ablations

Medial branch blocks and radiofrequency ablation (neurotomy) go hand in hand to best treat our patients who experience pain in the neck, mid back or lower back. This procedure is typically performed for patients with degenerative disc disease or arthritis in the spine. Before an ablation can be considered, we must first perform the medial branch blocks to determine if you are a candidate for the ablation. 

​What MBBs/RFAs do we offer?  

  • Cervical Medial Branch Blocks

  • Thoracic Medial Branch Blocks

  • Lumbar Medial Branch Blocks

  • Cervical Radiofrequency Ablation

  • Thoracic Radiofrequency Ablation

  • Lumbar Radiofrequency Ablation

Medial Branch Blocks

​What medication is used?  

  • Lidocaine

  • Bupivicaine

Why are the medial branch blocks performed first?

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Medial branch blocks are done first as a diagnostic tool to determine if you are a candidate for the radiofrequency ablation. To reach this determination, we inject local anesthetic to the nerves that branch out from the facet joint to see if you receive relief of your pain for a temporary period of time. These diagnostic tests are performed twice before proceeding with the ablation per insurance guidelines and requirements. The goal of these tests is to simulate the amount of relief the ablation will provide. 

What is the radiofrequency ablation?

After two successful medial branch blocks, you are now a candidate for a radiofrequency ablation. This ablation typically provides relief of your pain for 8-12 months or longer. This procedure is performed by placing a needle and probe at the same medial branches that we tested with the medial branch blocks. Once the needle is placed accurately which is determined by utilizing fluorscopic guidance, we begin the cauterization process at each level previously tested. You may experience discomfort at the treated levels for 2-8 weeks after the procedure. Side effects of this procedure can include: a superficial burning sensation / sensitivity to touch, a sunburn-like sensation or numbness over the treated area.  

Radiofrequency Ablation

What are the benefits?

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The goal of this procedure is to not only improve your pain and symptoms, but to also improve your mobility and allow you to participate in your daily activities with less pain. While the greatest benefit of having a radiofrequency ablation is achieving relief of your pain, for some patients, there are many other benefits! The other benefits to achieving relief of your pain with this treatment are: 

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  • limiting or discontinuing the amount of medication taken to relieve your pain

  • continuing or starting physical therapy

  • returning to the activities that make you happy

  • postponing surgery

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