Medial Branch Ablation for Facet Joint Pain
Medial branch ablation is facet joint radiofrequency ablation for chronic back or neck pain from the facet joints. After a confirming medial branch block, request a consultation with Dr. John Smirniotopoulos to review whether this option is a fit.
Typically outpatient, with light sedation rather than general anesthesia
The procedure
Medial branch ablation for facet joint pain
Radiofrequency energy is applied to the medial branch nerves so they stop relaying pain from the facet joints. It is one option among spine treatments at Full Motion Joint and Spine — often after a diagnostic block, and never a promised result.
Not a disc operation
Not fusion. One-sided buttock pain may be SI joint ablation. Endplate-driven ache may be BVNA.
MedStar procedures
Done in the MedStar hospital setting. Visit flow is on the Locations page.
Request a consult
Request a consultation so candidacy is decided in person — not from this page.
The facets
Facet joint pain in the back or neck
Facet joint pain often worsens with twisting or extension. A medial branch block may come first. This is radiofrequency ablation for back pain (and selected neck facet pain) — not a treatment for every “arthritis” line on an MRI.
The nerves
Facet rhizotomy along the medial branch nerves
Guided by X-ray, radiofrequency energy is applied to the medial branch nerves. People sometimes call this facet rhizotomy. The visit plan — including whether a block is used first — is set at consult.
Candidacy
A consult after a confirming block
People ask about medial branch ablation when injections help only briefly and a block points to the facets. Dr. John Smirniotopoulos decides candidacy in person — not from this page.
Often discussed at consult
- Chronic back or neck pain thought to come from the facet joints
- A diagnostic medial branch block that helped, when one is used
- Interest in outpatient radiofrequency instead of a large spine operation
Candidacy is confirmed in person — not from this page.
Not every arthritis MRI
Stenosis walking pain, a fracture, or SI-pattern pain can point to a different tool.
New bowel or bladder loss, fever with back pain, or trauma with sudden severe pain needs urgent care — not this page.
The visit
Your medial branch visit, start to finish
Before you arrive
History, exam, and films. A block may be scheduled first. See Locations.
The day of treatment
Outpatient image-guided radiofrequency. Arrange a ride home.
Going home
Typically same-day discharge when the visit goes as planned.
Follow-up
Relief can last many months. Nerves may recover; repeat treatment is sometimes discussed. No duration is promised.
Afterward
Recovery after medial branch ablation
Needle-site soreness can occur. If this is not the match, options include conservative care, SI ablation, or surgical evaluation with your existing team.
Care led by
Dr. John Smirniotopoulos
Medial branch ablation is performed by a dual board-certified interventional and diagnostic radiologist, Associate Professor of Radiology at MedStar Georgetown University Hospital, fellowship-trained in vascular and interventional radiology (2020). Credentials are on the About page.
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Dual board-certified Interventional & Diagnostic Radiology
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American Board of Radiology
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Associate Professor of Radiology MedStar Georgetown
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Society of Interventional Radiology SIR
Before you book
Facet ablation questions we hear at consult
What is medial branch ablation?
Facet joint radiofrequency ablation of the medial branch nerves. A confirming block is often used first. Results vary.
Can it help neck pain from the facets?
Selected neck facet pain is discussed the same way as lumbar facet pain. Candidacy is confirmed in person.
Is it outpatient?
Yes. It is typically outpatient with same-day discharge when the visit proceeds as planned.
How is it different from SI joint ablation?
SI joint ablation treats the joint where spine meets pelvis. Medial branch work is for the facet joints.