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Medial Branch Radiofrequency ablation

Date issued: August 2023

Review date: August 2025

Ref: B-467/Pain Management/Medial Branch Radiofrequency ablation v3

PDF:  Medial Branch Radiofrequency ablation final August 2023 v3.pdf[pdf] 219KB

Why has this been suggested as a way of helping with my pain?

  • You will have had an injection into your back prior to this that gave you good, but short lived, improvement in your pain.

  • Your consultant thinks that radiofrequency ablation could extend this improvement in pain to allow you to move more freely and engage in physiotherapy and positive lifestyle changes. 

What is radiofrequency ablation of medial branch nerves?

  • These are injections that are targeted at small nerves in your lower back.

  • The needle is attached to a special machine that allows the tip to be heated: this affects the structure of the nerve the needle lies against.

  • We perform these in sterile conditions and under x-ray guidance in University Hospitals Plymouth. 

How do they work?

  • The injections can provide some pain relief by resetting the nerves that might be giving the signals of pain. 

How long will the pain relief last?

  • There is potential for this injection to provide prolonged pain relief and we hope that it would allow you to do more gentle activity, physiotherapy and positive lifestyle changes that will also help.

You must fast unless otherwise advised.

You must inform the Pain team if:

  • You have had any form of infection during the 14 days before your procedure


  • You are on drugs that thin the blood or suffer with a problem that means your blood doesn’t clot normally 

What are the side effects of the treatment?

  • It is possible to worsen your symptoms with these injections

  • Very occasionally temporary numbness in the legs and buttocks that will wear off, after several hours. However it is possible for this to be permanent.

  • Some bruising and short term back pain is possible but should settle following a week or so.

  • Spinal infections or bleeding can occur in rare circumstances; these are potentially very serious. 

What happens immediately after the injection?

  • You will be asked to report whether your pain is better and may be asked to do things that would normally provoke your pain. 

Before you are discharged

  • You will be helped to your feet, to check your walking ability.

  • Occasionally the injection can affect your legs making them feel numb or weak. This is in the main a temporary problem wearing off after a few hours.

  • You will be asked to pass water before being allowed to go home.

Post procedure advice

  • You must not drive yourself home and you should have someone with you at home for 24 hours

  • A temporary flare of pain is sometimes reported but this should last only up to a week or so.

  • Slowly start to increase your movement in the weeks following the injection. Why not start by trying some gentle Tai Chi.

  • Consider trying mindfulness relaxation techniques.

  • Your pain consultant may have referred you for physiotherapy, if not you can self-refer, for advice about improving your activity and endurance.


  • If you have new leg weakness, or new problems with bowel or bladder control, with new back pain or fever in the weeks following your injection please seek urgent medical advice.

  • You should either ring:   

    • Your GP.

    • NHS 111.

    • Pain Clinic (in office hours) 01752 437706.

    • Or attend Derriford Emergency Department.

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