Inclusion Criteria:  Adult age 18-75 (inclusive) DEERS eligible Able to understand, read and speak English Willing and able to provide written informed consent Predominant area of pain is axial low back pain Chronic low back pain lasting more than 3 months Average daily numerical pain rating of at least 4 out of 10 Single positive diagnostic medial branch block (MBB) of greater than or equal to 50% reduction in symptoms after local anesthetic injection  Exclusion Criteria:  Prior spinal intervention such as epidural steroid injection or sacroiliac joint injection for current symptoms Prior radiofrequency denervation for facet mediated pain History of lumbar fusion Allergic to local anesthetic such as lidocaine and ropivacaine On opioid medication greater than or equal to 50 MME Recent (within past 3 months) systematic or localized infection Spinal pathology such as symptomatic radiculopathy or spinal stenosis within the past 3 months Medical or psychological condition that would preclude safe participation in study procedures (e.g. uncontrolled coagulopathy, diabetes, uncontrolled immunosuppression, inflammatory arthritis, active malignancy, uncontrolled depression or anxiety, etc.) Service member currently going through medical evaluation board Scheduled to move, deploy, separate or retire within 6 months Unable or unwilling to comply with study requirements Currently pregnant or had a recent delivery (within past 3 months)