Radiofrequency ablation is usually the next step after a positive medial branch block. Using a specialized needle guided by X-ray, gentle, controlled heat quiets the small nerves carrying facet pain signals — with no incision and no implant.
How RFA Works
After a test block confirms facet pain, we place a specialized needle using X-ray guidance and apply gentle heat to the medial branch nerves. It is an outpatient procedure. You go home the same day.
What Relief to Expect
About two out of three carefully selected patients get significant, lasting relief — often for six months to a year, sometimes longer. Because the small nerves slowly recover, pain can eventually return. The good news: if you responded well the first time, repeating the procedure is safe and tends to work again. Many patients return every year or so and stay comfortable that way for years.
How RFA Differs From Endoscopic Rhizotomy
Standard RFA treats the nerve through a needle placed using X-ray landmarks. Endoscopic rhizotomy goes one step further: a tiny camera through a pencil-width incision lets the surgeon see the nerve and divide it completely. Relief from endoscopic rhizotomy tends to last notably longer. It is still a same-day procedure and a good option when RFA relief keeps wearing off.
Related Care
- Facetogenic Back Pain: Causes, Symptoms & Treatment Options
- Medial Branch Block
- Endoscopic Spine Surgery
- Back Pain video series
This page is for general education only and is not a substitute for professional medical advice, diagnosis, or treatment. Please consult a qualified physician about your specific condition.