The procedure is typically performed on one side at a time at multiple joint levels. After the skin is anesthetized and the needles are correctly positioned under fluoroscopic (x-ray) guidance, an electrode is placed through the needles, causing sensory and/or motor stimulation. This non-painful stimulation confirms that the needles are correctly positioned over the painful nerve of interest. The nerves are then carefully anesthetized for several minutes. Once the nerves are properly numbed, the tip of the needle is then heated by the probe through radio frequency up to 60-85 ⁰C for 1-2 minutes, resulting in denervation of the nerve. Afterwards, additional anesthetic solution and a small amount of steroid is deposited before the needle is removed.
Radiofrequency ablation will result in the same pain relief experienced with the medial branch block, but the pain relief will last for at least 6-9 months, with many patients experiencing pain relief for 12-18 months or more. The medial branch nerves will regrow and, should the patient’s pain return at that time, the procedure can be repeated after 6 months or more. Potential complications of the procedure are rare, but include bleeding, infection, temporary worsening of pain symptoms, and sensitivity at the injection sites. Multiple, large evidence-based studies have shown radiofrequency ablations to be among the most successful procedures in the diagnosis and treatment of chronic joint pain.