Rami Communicans Pulsed Radiofrequency and Block

The rami communicantes are small nerve branches that carry pain signals from the intervertebral discs and connect the spinal nerves to the sympathetic chain, and are an important treatment target for chronic discogenic back pain — pain arising directly from a damaged or degenerated disc rather than a nerve root or facet joint. This procedure aims to reduce pain signalling along this specific pathway.

A diagnostic block with local anaesthetic is performed first, under X-ray guidance, to confirm these nerve branches are contributing to your pain. Where this produces clear, temporary relief, pulsed radiofrequency treatment is applied to the same nerves, using short bursts of electrical energy to modulate pain signalling.

This treatment is generally considered for carefully selected patients with confirmed discogenic pain that has not responded to more conservative measures, and where other structural causes (such as facet joint or nerve root pain) have been excluded. Dr Danesh will discuss whether this approach is appropriate for your specific pain pattern.