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Pain medicine · UK

Medial branch block + facet RFA - consultant-led, done properly.

Consultant-pain-medicine-led diagnostic medial branch blocks and, if positive, radiofrequency ablation (RFA) of the facet joint nerves for chronic facet-driven back or neck pain.

A stethoscope on a clinical desk

Indicative pricing

What private medial branch block + facet rfa costs in the UK.

Indicative ranges across UK private providers.

In short

Diagnostic MBB then RFA (both sides, lumbar): £900–£1,800 per stage; usually 2 stages total.

Option Indicative range
Consultant pain-medicine assessment £300–£550
Diagnostic medial branch block (one level, one side) £450–£850
Diagnostic MBB (bilateral, 2–3 levels) £900–£1,600
Confirmatory second MBB (if first positive) £900–£1,600
Radiofrequency ablation (bilateral, lumbar) £1,200–£2,400
RFA - cervical (specialised) £1,500–£2,800
Follow-up (6 weeks post-RFA) £200–£350

Prices vary by clinic, by the consultant’s seniority, and by whether combinations are used.

The problem

A precise diagnostic, not a shotgun injection.

MBB-then-RFA works when the facet joints are actually the pain generator - and only then. The whole pathway is a diagnostic tool as much as a treatment.

  • Consultant, not delegated

    The consultant who assessed you should be the consultant who treats you - not a junior on a busy list.

  • Evidence, not sales

    The recommendation is what fits your clinical picture - not what the clinic wants to sell you today.

  • Written pathway, not verbal promise

    The plan, the prices and the follow-up are in writing before you commit - not surfaced when the invoice arrives.

Who it suits

When MBB and RFA are the right choice.

The patients who benefit most, and when physiotherapy, disc-directed treatment or SCS is used instead.

  • You have thought about this for a while

    Not an impulse - a decision you have carried and want to act on properly.

  • You want the right treatment, not the fastest

    You want to be seen by a consultant who does this every week, not the next available diary slot.

  • You have tried the obvious first steps

    GP care, over-the-counter routes, or first-line therapy - and the problem is still there.

  • You are otherwise well enough to proceed

    Stable on medication, not acutely unwell, not in a flare that would postpone treatment.

  • You are willing to follow the plan

    Attend the follow-up, take the medicines, do the physio - whichever this treatment needs to work.

  • You are prepared for the recovery

    You have thought about time off work, help at home and - where relevant - the cost of ongoing care.

  • You want a named consultant, not a rotating list

    The person who assesses you should be the person who treats you and reviews you afterwards.

  • Red flag: you were declined elsewhere on medical grounds

    If another consultant has said no on medical grounds, ask them to explain why before seeking the same treatment elsewhere.

Options

Lumbar, cervical, or thoracic facet pathways.

The three spinal regions this pathway covers, and how each is done.

  • Assessment and shared decision

    A full consultant hour and honest expectations conversation - the difference between a treatment that suits you and one that only suits the clinic.

  • First-line treatment

    What most patients start with, and what most get on with well.

  • Course-based or staged treatments

    Some treatments deliver over three to six visits or in stages.

  • Combined modality

    The strongest outcomes often come from combining approaches - medical, procedural and behavioural. Plans work best across the year, not the visit.

  • Maintenance

    Most conditions need ongoing care after the initial treatment. It helps to build this into the plan up front so the real commitment is clear.

  • Alternatives to consider

    Where a different treatment might suit better, a good consultant will say so - including newer or older options that the marketing does not push.

  • Escalation pathway

    What happens if this treatment does not work - the next option, in writing, before you start.

  • When to say no or refer

    For patients who fall outside criteria, the usual approach is referral to the right specialist or back to NHS care rather than treatment regardless.

Safety and recovery

What to expect afterwards - honestly.

Consultant-led private care is generally low-risk. The things worth planning are candidacy, dose or intensity, downtime and what happens if something is not right.

  • A named UK consultant, in a CQC-regulated setting

    The consultant who assessed you should be the consultant who treats you. That single change avoids many preventable safety problems.

  • Realistic outcomes, spelled out

    What this treatment can and cannot do - and what happens if it does not work. If you are hoping for something this treatment cannot deliver, it is better to know before you book.

  • Written pre-care and aftercare

    What to do before, on the day, and after - including medication changes, contraindications and warning signs. In writing and by message, not verbally in a corridor.

  • Rare but serious risks

    Every treatment has its own list. The consultant discusses them at consent - not glossed, not exaggerated. You take those notes home.

  • Contraindications matter

    Pregnancy, active infection, uncontrolled cardiovascular disease, immunosuppression, bleeding tendency and drug interactions - all reasons to postpone.

  • A same-day contact number

    Written aftercare plus a phone number that answers on the day. Complications improve dramatically with early intervention, and hard to reach clinics cost lives.

  • Included follow-up

    A good pathway books the review appointment before you leave and includes it in the price, rather than billing separately when something is not right.

  • Escalation to hospital where needed

    Any private pathway has to have a plan for when things escalate - which hospital, which team, and how to get there.

  • Written record and second opinion

    You leave with the record, the images and the plan - enough for another consultant to pick up if you ever want a second opinion.

Reading your treatment record

Your treatment record in four parts. Read the last one first.

Whichever pathway you chose, the record the clinic sends you keeps to the same shape.

A consultant reviewing a treatment record

A quiet reminder

Keep every note, batch and image on file - it matters if you ever need a second opinion.

If you hold a record from another clinic, bring it to your next visit.

  1. 01 Assessment

    What was recommended and why

    The consultant’s written note - history, examination, differential and the plan agreed with you. Read this alongside the pathway.

  2. 02 Procedure / Treatment

    What was actually done

    The named procedure, materials, medicines and settings used. Keep this - it matters for future care and for any second opinion.

  3. 03 Findings

    What was found or measured

    Any pathology, imaging or intra-procedural findings. Written in plain English alongside the technical terms.

  4. 04 Plan

    Follow-up, medication, warning signs

    Read this first: when to come back, medication changes, what is normal, and what needs a same-day phone call.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Insurance cover for this pathway varies by policy - some elements may be covered, others self-pay. Where NHS provision exists but is delayed, private care is the practical route.

Frequently asked

Common questions about medial branch block + facet rfa.

Quick answers on candidacy, safety, cost and outcomes.

  • Is MBB or facet RFA available on the NHS?

    Yes, via NHS pain-medicine clinics, but access varies by ICB and waits can be 6–12 months. NICE guidance NG59 supports RFA for medial branch pain confirmed by two positive diagnostic blocks - private access uses the same evidence base.

  • Why two diagnostic blocks before RFA?

    To reduce false positives. A single positive block can be placebo. Two positive blocks with different anaesthetics is the standard before committing to RFA. Skipping the second block is a common short-cut that gives worse RFA outcomes.

  • How much does private MBB and RFA cost in the UK?

    Roughly £900–£1,800 per stage - first diagnostic block, confirmatory block, then RFA if both are positive. Total for a lumbar bilateral pathway typically runs £3,000–£5,500 including consultation and follow-up.

  • How long does RFA last?

    Six to eighteen months in most patients, with a subset getting longer. Nerves regenerate over time and RFA can be repeated when pain returns. Around 60–70% of correctly selected patients get meaningful relief from the first RFA.

  • What are the risks?

    Transient soreness at injection sites, a small risk of infection, and - very rarely - nerve injury or bleeding. Fluoroscopic (X-ray) guidance is standard; the procedure is done awake with local anaesthetic.

  • Is this a cure for back pain?

    No - it treats facet-driven pain specifically. It does not treat disc, muscle or neuropathic pain. Careful clinical selection plus positive diagnostic blocks is what makes the difference between a working RFA and a wasted one.

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