If the block confirms facet or SI joint pain
- RFA for longer-lasting relief
- Optional: joint injection with steroid or prolotherapy
Pain-medicine specialist–led care
Chronic Back Pain Treatment
Midline facet or SI-joint pain, or sciatica-type pain radiating down the leg — we confirm the source with targeted diagnostic blocks and MRI, then treat it with image-guided procedures from RFA to epidural steroid injection and balloon neuroplasty.
Pain-medicine specialist–led care
Where does chronic back pain come from?
Chronic low back pain has several possible sources — the muscles, the facet joints, the sacroiliac (SI) joint, or a nerve root compressed by a herniated disc. Each one is treated differently, so confirming the source comes first.
At YOUNIFY we use targeted diagnostic injections and MRI (for radiating symptoms) to identify the pain generator, then treat it with minimally invasive, image-guided procedures — most of them same-day.
When to see a specialist
- Back pain lasting beyond 3 months despite medication and physiotherapy
- Pain radiating down the leg, numbness, or tingling
- Pain that limits standing, walking, or sleep
- You want options before considering surgery
Back pain care pathway
Two symptom patterns, two pathways — choose the one that matches your pain
Midline back pain
Pain confined to the back without radiating down the leg — usually facet joints, the SI joint, or muscle
01
Diagnostic medial branch block / SI joint injection
Depending on the suspected source, a small local-anaesthetic injection tests the facet joints or the sacroiliac joint. Clear relief confirms the pain generator.
02
Read the response
Relief points to facet joint or SI joint pain. Little or no relief usually means muscular pain, managed with physiotherapy, massage, and trigger point injections.
03
Radiofrequency ablation (RFA)
Radiofrequency energy quiets the pain signal from the confirmed facet or SI joint — needle-sized entry, outpatient, fast recovery.
If the block brings no relief — muscle pain
- Physiotherapy and therapeutic massage
- Trigger point injection to release painful muscle knots
Every procedure is performed by a pain-medicine specialist, with image guidance — fluoroscopy or ultrasound — on every case.
Comparing back pain procedures
All options are minimally invasive, outpatient procedures
| Procedure | Best for | Image guidance | Invasiveness | Home the same day |
|---|---|---|---|---|
| Diagnostic medial branch block / SI joint injection | Confirming facet or SI joint pain | Fluoroscopy | Needle only | Yes |
| Radiofrequency ablation (RFA) | Confirmed facet or SI joint pain | Fluoroscopy | Needle only | Yes |
| Facet / SI joint injection (steroid / prolotherapy) | Adjunct for joint pain | Fluoroscopy | Needle only | Yes |
| Epidural steroid injection — transforaminal / interlaminar / caudal | Nerve-root pain radiating down the leg | Fluoroscopy (caudal: ultrasound possible at L5/S1) | Needle only | Yes |
| Pulsed RF of the nerve root | When ESI is unsuitable or insufficient | Fluoroscopy | Needle only | Yes |
| Epidural balloon neuroplasty | Persistent radicular pain with adhesions | Fluoroscopy | Fine catheter | Yes |
| Trigger point injection | Muscular back pain | Landmarks / ultrasound | Needle only | Yes |
Facet Joint Pain Treatment: Medial Branch Block & Radiofrequency Ablation (RFA)
Care for facet joint pain is delivered in two steps — first a diagnostic medial branch block (a test injection of local anaesthetic at the nerves supplying the joint) to confirm the source of pain, and if the pain eases clearly, treatment with radiofrequency ablation (RFA) by our medical team.
Medial Branch Block (diagnostic test injection)
A medial branch block is a test injection of local anaesthetic at the nerves that supply the facet joints. Its purpose is to confirm a diagnosis of facet joint arthropathy and to predict how well you may respond to nerve ablation, using X-ray guidance with contrast dye to confirm the nerve position and the spread of medication.
This injection is diagnostic, not a permanent treatment. If your pain eases clearly after the injection, the doctor will schedule radiofrequency ablation as the next step.
For diagnosis — not a permanent treatment
Radiofrequency Ablation (RFA)
RFA uses high-frequency radio waves to treat the nerves that carry pain signals from the inflamed joint, reducing pain without affecting the function of other nerves. It is offered to patients who respond to the medial branch block test with a clear reduction in pain.
- A test injection of local anaesthetic at the medial branch nerves (MBB) is given under X-ray and contrast guidance.
- You record your pain score in different positions every 2 hours for 24 hours.
- If the pain eases clearly, the doctor schedules radiofrequency ablation (RFA).
- RFA treats only the nerves carrying the pain, giving longer-lasting relief without affecting other nerves.
Who is it for? (indications for the test and treatment)
- People with chronic neck or back pain and suspected facet joint arthropathy.
- People whose pain is mainly in the neck, sometimes radiating to the shoulder blade or upper back.
- People whose pain is mainly in the lower back, sometimes radiating to the buttock or thigh.
Image-guided injection treatments for pain
Beyond radiofrequency ablation (RFA), several image-guided injection treatments are available, chosen by our medical team according to the cause of your pain. Preparation, aftercare, and precautions follow the same protocol described below.
Facet joint injection (steroid / prolotherapy)
An injection into the facet joint itself under X-ray guidance, to reduce inflammation and ease pain from a worn or inflamed joint. A steroid may be used to reduce inflammation, or prolotherapy to stimulate tissue repair — offered as an adjunct for patients confirmed to have facet joint pain.
Cervical Epidural Steroid Injection (ESI)
An anti-inflammatory medication such as a steroid, together with local anaesthetic, is delivered into the epidural space to reduce inflammation of the nerves supplying the arm or leg. It is performed under X-ray with contrast dye to confirm the position, and suits people with pain radiating to the arm or leg from a herniated disc or spinal stenosis that has not responded to medication and physiotherapy. On average the pain relief lasts about 2–3 months, and it also helps pinpoint the source of the pain.
Relief without surgery · about 2–3 months on average
Selective Nerve Root Block
An injection targeted precisely at the specific nerve root causing the pain, under ultrasound or X-ray guidance. It both confirms which nerve root is responsible and reduces inflammation at that point — suited to people with pain clearly radiating along a single nerve root.
Preparing for the procedure
- Avoid food and drink for at least 6 hours before the injection.
- Tell the doctor about any underlying conditions, allergies to local anaesthetic or contrast dye, or blood-thinning / anticoagulant medication — especially warfarin or clopidogrel.
- On the morning of the procedure, take only the regular medication your doctor advises, and skip your morning painkillers so the doctor can judge the true result.
- Bring a relative or carer with you, as no hospital stay is required.
When it should not be done
- A skin infection at the injection site.
- Pregnancy, or suspected pregnancy.
- A history of allergy to local anaesthetic or contrast dye.
- A cardiac pacemaker, or inability to lie face-down for long — for the RFA step.
After the procedure
- You are observed in the recovery area for about 30–60 minutes.
- Record your pain score at home every 2 hours for 24 hours and bring it to your follow-up (in some cases you may email or send a photo via LINE).
- If your pain improves clearly, the doctor schedules radiofrequency ablation (RFA) as the next step.
- You can resume normal daily activities, but should avoid driving yourself after the injection.
Possible complications
- In the first 1–2 days you may have pain or soreness at the site — a cold compress is recommended.
- Pain may not ease immediately, or may briefly increase from inflammation, and you may feel temporarily dizzy.
- Allergy to local anaesthetic or contrast dye, or bleeding / infection at the site (uncommon).
- If a steroid is used, temporary side effects may occur, such as menstrual changes, acne, weight gain or facial/body swelling, and a temporary rise in blood sugar — especially in people with diabetes.
- Neurological complications from injury to a nerve or the spinal cord are very rare.
Price list
ProcedureStarting Thailand price (฿)Starting Thailand price (AUD)Standard Australia price (AUD)
Back pain treatments
Dry Needling650A$28—
Wet Needling1,800A$78—
Medial Branch Block (diagnostic)22,000A$957A$1,100
Radiofrequency Ablation (RFA)45,000A$1,957—
Epidural Steroid Injection80,000A$3,478A$5,500
Pulsed Radiofrequency45,000A$1,957—
Epidural Balloon Neuroplasty170,000A$7,391—
* Indicative prices for reference only. Final pricing depends on an individual assessment. Overseas prices are indicative market estimates for comparison only — contact our team for a personalized quote.
FAQs
Common questions about back pain procedures
Which epidural steroid injection route will I get?
Your doctor chooses among the transforaminal, interlaminar, and caudal routes based on your MRI findings, the level involved, and your anatomy — the goal is to deliver medication as close to the irritated nerve root as possible.
How long does RFA last?
Relief typically lasts many months and the procedure can be repeated if the pain returns. Individual results vary.
Will I need surgery?
Most patients without weakness or spinal cord compression can start with these minimally invasive options. If surgery is genuinely indicated, our team will coordinate the referral.
Get your back pain properly diagnosed
Book an assessment with our pain-medicine team and find the pathway that matches your symptoms.
Reviewed by The YOUNIFY Clinic medical team · Last reviewed
Individual results may vary. Please consult a doctor before treatment.