Medial Branch Nerve Radiofrequency Ablation
Procedure Description:
A medial branch nerve radiofrequency ablation (MBN RFA) is a targeted delivery of heat using small needles to the medial branch nerves (MBN) to interrupt pain signals coming from spinal joints (facet joints). Typically MBN RFA is recommended after two sets of MBN blocks with substantial temporary relief or a previous MBN RFA with substantial sustained relief. Over time, nerves previously treated with MBN RFA can “wake up” and start sending pain signals again and repeat RFA can be considered. This is a commonly performed procedure with a low risk of side effects.
What it treats:
Neck pain, upper back pain, lower back pain arising from injured or arthritic spinal joints. This usually presents as pain and stiffness closer to the spine, aggravated with movement, spinal extension, and worse in the mornings and at the end of the day.
How it is performed:
A MBN RFA is performed using a special X-Ray machine called a fluoroscope. This allows the provider to target the treatment quickly and effectively. The procedure typically takes less than 30 minutes. The provider numbs the area before the injection to minimize discomfort.
Pre-procedure instructions:
Wear loose clothing without metal buttons or zippers to the procedure. Typically the procedure is performed with IV sedation so make sure to not eat or drink for 12 hours prior to the procedure. Also, no driving is advised for 12 hours after the procedure, so a driver home is required. If IV sedation is administered, the driver must be a friend or family member. If no IV sedation, then can be a ride service such as Uber. If on a medicine that prevents blood clotting (aspirin, coumadin, Plavix, Eliquis, Xarelto, etc), this will need to be held prior to and after the procedure with the prescribing physician’s permission. Make sure to inform your provider if you are on any blood thinners so additional instructions can be provided.
What to expect after the procedure:
After the procedure, there may be some mild increase in pain or soreness. It may take up to 2-3 weeks for the facet pain to improve after the RFA. Make sure to NOT increase activity too quickly. In fact, we recommend you maintain your preprocedure level of activity for at least 2 weeks until the follow up appointment. You may remove the bandages later the same day and take a shower. We recommend avoiding swimming or a bath for at least 2 days. For procedure soreness, you may use ice as needed, 20” on and then 20” off.