Medial Branch Blocks: Cervical, Thoracic and Lumbar Spine

Who would benefit from this injection?

Individuals with pain secondary chronic or acute degenerative spine arthritis and facet hypertrophy.  Typically a person would have pain the primarily localized to the spine (neck, mid-back or lower back) without any radiation to the extremities.

How does this work?

The combination of a local anesthetic at times mixed with steroid is injected to anesthetize the medial branch nerve which innervates the facet joint which results in pain control.

How is the procedure done?

The patient will either lie on back (cervical) or abdomen (thoracic and lumbar).  The skin is first cleaned in proper surgical sterile fashion, the needle is than directed under x-ray guidance to its target and medication mixture (local anesthetic with or without steroid) is than injected.

What are the potential risks?

Although this is a very safe procedure, it is not without risk.  Whenever a needle is used there is always the risk of infection and bleeding.

What should I expect after the procedure?

It is normal to experience temporary soreness at the need placement sites. If effective pain relief is experienced within the first 30 minutes of the procedure.  The pain relief typically last several hours when local anesthetic is used alone or several days if steroids are added.

The medial branch injection is a diagnostic test; thus the benefit is supposed to wear off within a short time span 6 hours to several days.

If the medial branch block is effective in providing temporary pain relief, than it is repeated a second time to confirm that the medial branches are truly the source of your pain.

After completing both visits for your medial branch block with success of pain relief than this is followed by a procedure titled “radiofrequency ablation or Rhizotomy” of the medial branch nerves.  The radiofrequency ablation than provides improved pain control that can last 6 months or longer.

medial-branch-block