RFA (Radio Frequency Ablation) & Medial Branch Block’s (MBB’s) / Nerve Block
These procedures focus on chronic pain from arthritis in the spine. These procedures can be performed for both back pain (Lumbar Spine), and neck pain (Cervical Spine). Could this procedure be right for you?
This type of pain is typically experienced across the low back or across the neck. This is not the treatment for a ‘pinched nerve’, this does not treat pain radiating into the arms or legs (sciatica). If your pain continues despite physical therapy, at home rehab exercises, anti-inflammatories such as NSAIDS. If you experience chronic pain from prolonged standing, or rising from a chair, or perhaps you have a ‘stiff and sore neck’. You may be a good candidate for these procedures. This will be determined by your Doctor, and then the following steps will be taken.
Step 1
Medial Branch Blocks (MBB’s), are done using fluoroscopic guidance (live X-ray) at an outpatient surgery center using a C-Arm. Pictures from the C-Arm guide the needle precisely to the nerve, numbing medication is injected, and if your pain decreases by 80%, then you are going to be a good candidate to proceed towards the RFA. MBB’s are a diagnostic procedure only. The numbing medication and pain reduction typically only lasts a few hours.
This procedure has to be repeated twice, for verification and to make sure you are a good candidate for an RFA.
Step 2
Repeat required MBB’s to ensure you are a good candidate to proceed.
There are valid reasons why this needs to be completed twice. This is done to assure that your pain generators are indeed transmitted through these ‘Medial Branch nerves’ and that your pain will respond to this intervention. At times people may experience a reduction in pain, possibly from a placebo response simply from any procedure done to address their pain. This can be observed if performed only once, however, if the reduction in pain is reproduced, then you will likely respond well to a nerve ablation.
If pain is decreased by 80% following each of the two MBB’s, proceed to step 3.
Step 3
The RFA procedure is similar to the MBB, however, this time when the needle (RFA probe) tips are placed on top of the nerve, the needle tip will be turned on and will burn the nerve. You may experience increased pain and soreness for 24-48 hours.
Decrease in pain can be expected within a couple days, however pain decreases may take up to 2-4 weeks to be fully appreciated. Pain reduction can last 6 – 12 months, and sometimes up to two years, depending on the individual.