Medial Branch Pulsed Radiofrequency Therapy and Block

The medial branch nerves are the small sensory nerves that carry pain signals directly from the facet joints to the spinal cord, and are the specific target of this treatment for chronic facet-joint-related back or neck pain. Pulsed radiofrequency uses short bursts of electrical energy around the nerve rather than continuous heat, modulating how the nerve transmits pain signals while avoiding the higher temperatures used in thermal ablation.

As with all medial branch procedures, treatment begins with a diagnostic medial branch block — a precisely placed local anaesthetic injection under X-ray guidance to confirm that these nerves, and therefore the facet joints they supply, are genuinely contributing to your pain. A clear, if temporary, response to this block supports proceeding to pulsed radiofrequency treatment of the same nerves.

Pulsed radiofrequency is often selected in preference to thermal ablation where a gentler approach is appropriate, or near nerves where preserving normal motor or sensory function is a particular priority. Many patients experience a meaningful reduction in pain that can last for months, supporting a more active return to physiotherapy and daily function, with the option to repeat treatment if it proves beneficial.