If you have a positive response to a medial branch block, then the next step to obtain longer pain relief is a Radiofrequency Ablation (RFA).
A RFA is an electric current that is introduced to the nerves of the facet joints. The current is used to deaden a small area of the nerve and disrupt the pain signals that the nerve is sending to the brain. This is like temporarily shutting off/decreasing the nerve signals that are causing your pain. This is performed using small needle-like probes as demonstrated in the picture above.
For patient comfort, you may have the choice of mild sedation or pre-medication. For patient safety, an x-ray technique known as fluoroscopy guidance is utilizing for accurate needle positioning.
On average you can expect at least 70-80% pain relief that lasts anywhere from 4 to 6 months, followed by a slow increase in pain levels over the next 2 -3 months. After 6 months, the RFA can be repeated for continued pain relief.
With this procedure, it may take up to 6 weeks to start noticing pain relief due to initial nerve irritation caused by the procedure. Meanwhile, your provider will continue to manage your medication appropriately.