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Medical Branch Nerve Radiofrequency Denervation

Pain signals from individual facet joints are transmitted to the brain by medial branch nerves. These medial branch nerves only carry signals of pain. They do not control your ability to move. Since this nerve is transmitting pain, a small amount of numbing medication can be injected along the nerve to decrease the pain, which is called a medial branch nerve block. If you received benefit from the temporary medial branch nerve block, we can pursue radiofrequency ablation of the medial branch nerve, which should give long-lasting relief. This procedure blocks the function of the nerve for an average of 6-18 months.

How It Works

Medial branch nerve radiofrequency denervations are performed under live fluoroscopic guidance to ensure the accuracy and safety of this procedure.

  • You will be asked to lie on your stomach or side.
  • The area of the injection will be cleaned with an antiseptic, and a sterile drape will be placed.
  • Your Center for Pain Management physician will inject a numbing medication (local anesthetic) to numb the skin.
  • Radiofrequency ablation is performed using a specialized needle that is guided under live x-ray visualization to seat directly over the targeted medial branch nerve.
  • Radiofrequency energy is then transmitted via a probe inserted into the special needle. This needle allows the radiofrequency probe to create a focused heat lesion to “burn” or “cauterize” the medial branch nerve.
  • Radiofrequency denervation of this nerve therefore blocks the pain sensations originating from the facet joint.
  • Afterward, the needles will be removed, and a sterile dressing will be applied.


Potential risks — although very low — include infection, bleeding, allergic reaction, and prolonged increases in pain. Your physician will use x-ray guidance throughout the procedure and sterile techniques to significantly reduce any risks.

A few days after the procedure, it is normal to feel sore, which is controlled by analgesics and cold packs. Pain relief from this procedure usually occurs within the first two weeks, but the nerves may take 4 weeks to fully respond to the ablation.