Learning About Lumbar Medial Branch Block and Radiofrequency Ablation (nerve burn)

What are Lumbar Medial Branch Blocks and Radiofrequency Ablations (nerve burn)?

Lumbar facet joints connect your vertebrae to each other in your low back. These joints allow you to bend your back forward and backward. Like any other joint these can develop arthritis and can cause long-term pain in the back. They can sometimes affect the buttocks and legs as well.

Medial branch nerves are the nerves that carry many of the pain messages from your facet joints.

Radiofrequency medial branch ablation is a type of treatment that is used to relieve arthritis pain. It uses radio waves to damage nerves in your back so that they can no longer send pain messages to your brain.

Before I know if a nerve burn procedure will help you, I must do a medial branch block to confirm that certain nerves are the ones that are a source of your pain. Typically, two medial branch block procedures performed on separate dates are necessary, and required by most insurance companies, to confirm the source of pain and ensure the best outcome.

How are Lumbar Medial Branch Blocks done?

I will use a tiny needle to numb the skin where you will get the block. Then I will put the block needle into the numbed area. You may feel some pressure, but you should not feel pain. Using fluoroscopy (live X-ray) to guide the needle, I will inject the medicine onto one or more nerves to make them numb.

If you get relief from your pain in the next 4 to 8 hours, it's a sign that those nerves may be contributing to your pain and that the radiofrequency ablation (nerve burn) procedure described below may help decrease your pain and improve your function.

It takes 20 to 30 minutes to get the nerve blocks done. You can go home after you are observed in the recovery area. You will receive a one-day diary to record how much pain you have in the hours following the procedure. You will need someone to drive you home.

How is Medial Branch Radiofrequency Ablation (nerve burn) done?

I will use a tiny needle to numb the skin where the radiofrequency needle will enter the skin. You may feel some pressure. Using fluoroscopy (live X-ray) to guide the needle, I will send radio waves through the needle to the nerve for 60 to 90 seconds. The radio waves heat the nerves, which damage them.

It takes 20 to 45 minutes to get a Radiofrequency Ablation (nerve burn), depending on how many nerves are heated. You will probably go home 30 to 60 minutes later. You will need someone to drive you home.

What can you expect after a Radiofrequency Ablation (nerve burn)?

The procedure is minimally invasive with no incision. Some patients may feel sore or tender at the injection site at first (icing the area helps a lot). But, after a successful radiofrequency ablation (nerve burn), most people have pain relief right away. The full effect takes two to three weeks to set in. This procedure should last from 6 to 18 months. Sometimes, albeit rarely, the pain relief is permanent. If your pain does come back, it may mean that the damaged nerve has healed and can send pain messages again.

Can you drive to the procedure?

A numbing medicine will be used to give you short-term pain relief. It is important for you to bring a driver with you on the day of this procedure. You may feel some numbness after the injection and it will not be safe for you to drive. We CANNOT perform the procedure if you do not bring a driver.

What should you expect after the procedure?

You may feel some numbness in your buttocks and legs or arms and fingers. It will go away.

Before you go home, the staff will make sure you are able to stand up and bear weight on your legs.

You should call your doctor (225-400-9004) if you have any of the following:

  1. Pain that gets worse
  2. Numbness that does not go away
  3. Weakness
  4. Trouble with urination
  5. Signs of infection (redness, fever, swelling, or drainage from the site)

If you are unable to reach your doctor please go to the nearest emergency room and call us the next business day