Facet Block, Medial Branch Block and Radiofrequency Ablation
- With a facet block, your doctor injects a small amount of anesthetic and steroid into one of your facet joints – the small joints that support your spine and allow it to move. The injection, guided by advanced imaging, can relieve pain caused by arthritis or other factors. It may need to be repeated several times a year.
- A medial branch block is more of a diagnostic option, in which a test injection is used to numb the nerves that serve the facet joint. The block, outside the facet joint, will provide pain relief for only a day or so. But if it works, you may be a candidate for radiofrequency ablation.
- Radiofrequency ablation (rhizotomy) uses a probe, armed with an electrode, to disrupt communication in the nerves that supply the facet joint. If successful, it can bring pain relief for six to 24 months. It also can be repeated without causing long-term damage.
Painful and inflamed facet joint.
Anesthetic and steroid injection into the inflamed facet joint.
Heat is used to ablate the inflamed facet joint nerve.
Who Benefits?
If you have specific types of neck, middle back or lower back pain, you may be a candidate for these procedures. The procedures also may be used for chronic conditions affecting the knees, shoulders or other areas of the back.
The procedures are often employed to relieve non-radiating pain caused by arthritis and other factors. They are not used for sciatica or pain that shoots down the leg. The goal of radiofrequency ablation is to reduce pain, improve function, reduce medications and avoid surgery.
Are There Different Approaches to This Treatment?
There are variations of radiofrequency ablation (RFA), though each is used to disrupt the medial nerve branch that feeds the facet joint. Whether done with conventional RFA or water, the goal is to burn the nerve by delivering temperatures in the range of 140 to 170 degrees.
Recovery Expectations
These minimally invasive procedures do not require a hospital stay or time off from work or other activities. You’ll be asked to keep the procedure area dry and away from heat for a period of time.
The medial branch block takes about 15 minutes and can be done in the office setting or in surgery center under light sedation. Radiofrequency ablation is usually done in the surgery center.
