Radiofrequency Denervation and Brain Imaging

Inclusion Criteria: * Age 18 years or older * Chronic moderate to severe cLBP (defined by average pain intensity of ≥ 4 in the 11 point Numerical Pain rating scale and a minimum duration of 1 year) * Identified by clinical team as suitable for RFD pathway * Predominantly nociceptive pain (as defined by PainDetect score ≤12) * Stable on current analgesic regime * Able to communicate in English * Has the capacity to and agrees to give informed consent for participation in the study * Positive response to a single diagnostic MBB with 1 ml or less of local anaesthetic (bupivacaine 0.5%) at each level. (a positive response is defined as ≥80% pain relief at 3 hours, based on patient reported assessment) Exclusion Criteria: * Any patient whose physical condition will preclude them from lying still for the duration of the brain scan. * Contraindication to magnetic resonance scanning such as an implantable cardiac device. * Women who are, or may be, pregnant. (Pregnant patients do not undergo pain procedures under radiological guidance as per routine clinical care) * Significant anxiety and depression (as defined by HADS score ≥ 9) * Clinical suspicion that alternative diagnosis is the reason for LBP * Presence of chronic primary pain conditions (Fibromyalgia, chronic widespread pain, Complex Regional Pain Syndrome, Chronic Primary Headache, Orofacial pain, Chronic primary visceral pian and Chronic Primary musculoskeletal pain as defined by ICD-11 classification) * Presence of thor…