Lumbar medial branch blocks and Radiofrequency treatment for back pain

Lower back pain is one of the most common reasons people seek help from a pain specialist. For many people living with long-standing back pain, the problem is not a slipped disc or trapped nerve but irritation in the small joints of the spine, known as the facet joints.

When these joints become painful, treatments such as lumbar medial branch blocks and radiofrequency treatment can sometimes help.

Understanding Facet Joint Pain

Facet joints are small joints at the back of the spine that help guide movement and provide stability. Like any joint in the body, they can develop arthritis, inflammation, or wear and tear over time.

Facet joint pain often causes:

• Aching pain in the lower back

• Pain that is worse with standing or walking

• Pain when leaning backwards

• Stiffness in the morning

• Pain that may spread into the buttocks or hips, but usually not below the knee

Because these joints are deep within the spine, it can be difficult to confirm that they are the true source of pain. This is where medial branch blocks are helpful.

What Is a Lumbar Medial Branch Block?

A medial branch block is a diagnostic injection used to identify whether facet joints are the cause of pain.

Tiny nerves called medial branch nerves carry pain signals from the facet joints to the brain. During the procedure, a small amount of local anaesthetic is injected around these nerves using X-ray guidance.

The aim is simple:

If temporarily numbing these nerves reduces the pain, it suggests that the facet joints are likely to be the source of symptoms.

What happens during the procedure?

The procedure usually takes 15–20 minutes.

Patients typically:

1. Lie comfortably on an X-ray table

2. Have the skin cleaned and numbed with local anaesthetic

3. A very fine needle is guided into position using fluoroscopy (live X-ray)

4. A small amount of local anaesthetic is injected

Most people recover very quickly and go home shortly afterwards.

How do we know if it has worked?

After the injection, patients are asked to monitor their pain carefully over the following hours.

If the pain improves significantly while the local anaesthetic is working, it suggests the facet joints are involved. In that case, a longer-lasting treatment called radiofrequency denervation may be considered.

What Is Lumbar radiofrequency treatment?

Radiofrequency treatment (sometimes called radiofrequency denervation or rhizolysis) aims to provide longer-lasting relief from facet joint pain.

Using a specialised needle, controlled heat generated by radiofrequency energy is applied to the medial branch nerves. This interrupts the pain signals travelling from the facet joints.

Because the nerves eventually grow back, the treatment does not permanently damage the spine. Instead, it aims to provide months of pain relief while allowing people to rebuild strength and function.

How long does the relief last?

Results vary between individuals, but many patients experience relief for 6–12 months, and sometimes longer.

The nerves can slowly regenerate over time, meaning symptoms may gradually return. If the treatment was helpful initially, it can often be repeated safely.

Are these procedures safe?

Both medial branch blocks and radiofrequency treatments are commonly performed procedures in specialist pain clinics.

Serious complications are rare. Potential risks include:

• Temporary soreness at the injection site

• Bruising

• Temporary numbness

• Infection (very uncommon)

• Nerve irritation (rare)

Your pain specialist will always discuss the risks and benefits carefully before treatment.

Part of a bigger pain management plan

It is important to remember that injections are not a cure for chronic pain.

Instead, they can create a window of opportunity where pain is reduced enough to focus on:

• Gentle movement and physiotherapy

• Strengthening the spine and core muscles

• Improving sleep and wellbeing

• Gradually returning to meaningful activities

At Wye Sanctuary Pain Clinic, we focus on a holistic, patient-centred approach to persistent pain, combining medical treatments with education, self-management strategies, and supportive care.

When Might These Treatments Be Considered?

Lumbar medial branch blocks and radiofrequency treatment may be appropriate when:

• Back pain has lasted several months or longer

• Imaging suggests facet joint arthritis or degeneration

• Physiotherapy and medications have not been sufficient

• The pattern of pain suggests the facet joints may be involved

A specialist assessment is always required to determine whether these treatments are likely to help.

Seeking advice

If you are living with persistent back pain and would like specialist advice, an assessment with a pain consultant can help explore the possible causes and discuss the treatment options available.

You can learn more or book an appointment at:

www.wyesanctuary.com