Medial Branch Nerve Block

What is a medial branch block?

A medial branch block is an injection of a strong local anesthetic on the medial branch nerves that supply the facet joints. The facet joints, also known as the zygapophysial joints, are part of the bony framework of the spine. Sometimes, due to a variety of acute and chronic conditions, the facet joints can become inflamed.

What is the difference between cervical and lumbar medial branch blocks?

When pain is in the neck (cervical) facet joints, the pattern of pain is an achiness in the neck. Some patients may experience slight radiation across the neck and shoulders, and worsening symptoms with turning the head from side to side or looking up.

When pain is in the lower back (lumbar) facet joints, the pattern of pain is usually an achiness in the low back. Lower back pain may radiate across the lower back and slightly down the back of the buttocks and upper thighs. Symptoms may be worsened with bending over and prolonged standing.

How is the procedure performed?

The procedure is performed with you lying on your stomach. The skin on the back is cleansed with antiseptic solution, sterile drapes are placed over your skin, and x-ray guidance is used to ensure proper placement and positioning of needles. Once proper placement is confirmed very small needles are placed along the bony landmarks that mark the location of the medial branch nerves.

How long does the procedure take?

The actual injection takes only a few minutes. Please allow about 45 minutes for the procedure; this will include talking to your doctor before the procedure, signing the informed consent, positioning in the room, and observation by the nurse afterwards.

What should I expect after the procedure?

Shortly after the injection, you may notice that your pain may be gone or considerably less. This is because of the local anesthetic and you will be reminded that the pain relief will only last a couple hours following the procedure. If you do not obtain reasonable relief from this diagnostic injection, it is unlikely you will obtain relief from radiofrequency lesioning. Your doctor will discuss this with you.

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