Medial Branch Nerve Block
A medial branch nerve block is a procedure used to determine whether the facet joint is the source of a patient’s pain and also to provide immediate temporary pain relief.
It is primarily a diagnostic procedure but can also provide temporary pain relief.
The medial branch nerves are small nerves that generate from the facet joints in the spine. They carry pain signals from the facet joints to the brain. Arthritis or degenerative changes can cause the cartilage inside the facet joint to break down and become inflamed, triggering pain signals in the medial branch nerves.
Medial branch nerve block is used to determine for certain if the facet joint is the source of your back pain. It involves injecting an anesthetic near the medial branch nerves that are connected to a specific facet joint. The anesthetic is injected to numb or block the medial branch nerves from sending pain signals to the brain. If you experience up to 50% pain relief immediately after the anesthetic is injected, then the facet joint is determined to be the source of your pain.
Medial branch nerve block is a prerequisite for medial branch radiofrequency ablation. Only patients that experience pain relief from medial branch nerve block are qualified for medial branch radiofrequency ablation.
Medial Branch Block Procedure
First, you will be asked to lie down on your stomach. You will be given an IV line to help you relax and feel comfortable throughout the procedure. Your doctor will clean the injection site and apply a numbing agent to numb the skin area so that you don’t feel pain.
Using fluoroscopy guidance, your doctor will direct a small hollow needle towards the medial branch nerves. Your doctor will be able to view the direction of the needle on a monitor.
When the needle is in the right position, a contrast dye will be injected to help your doctor see the area more clearly to ensure that the medication will cover the area of the medial branch nerves.
When the needle is properly placed, your doctor will then inject a small amount of anesthetic onto the targeted nerves. The anesthetic numbs the nerves.
Nerve Blocks for Pain Relief: Types, Uses, and Side Effects
The types and uses of nerve blocks for pain relief include:
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Lumbar Medial Branch Block
The lumbar medial branch nerves are the medial branch nerves found around the facet joints at the lumbar (lower) part of the spine.
Lumbar medial branch block is the medial branch block of the lumbar medial branch nerves. People with lower back pain may have lumbar medial branch block.
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Thoracic medial branch block
Thoracic medial branch nerves are the medial branch nerves found around the facet joints at the mid-back or upper back.
Thoracic medial branch block is the medial branch block of the thoracic medial branch nerves. People with mid-back or upper back pain may have thoracic medial branch block.
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Cervical medial branch block
Cervical medial branch nerves are the medial branch nerves found around the facet joints at the neck region.
Cervical medial branch block is the medial branch block of the cervical medial branch nerves. People with pain in their neck region may have cervical medial branch block.
FAQs
How long does a medial branch nerve block last?
A medial branch nerve block can provide immediate pain relief that lasts for a few hours. Medial branch radiofrequency ablation provides longer-lasting pain relief that can last for 1-2 years.
How painful is a medial branch block?
The injection of a medial branch block feels like a slight pinch. Most patients don’t feel any pain when the injection is given.
What is the next step after a medial branch block?
When the doctor has confirmed that the facet joint is the source of the pain, then a medial branch radiofrequency ablation will be conducted. A medial branch radiofrequency ablation provides longer-lasting pain relief.
Medial branch radiofrequency ablation involves burning the nerves transferring the pain signals with radiofrequency heat. When the nerves are burnt, they can no longer transfer pain signals to the brain. It will take about a year or more for the burnt nerves to regrow. This means patients will experience pain relief as long as the nerves don’t grow back.
How long do medial branch blocks take to work?
Medial branch nerve block provides immediate pain relief. When the anesthetic is injected, it numbs the nerves immediately and provides immediate pain relief that lasts for a few hours.
How long should you rest after a nerve block?
When the anesthetic is injected, you will be allowed to rest for 15 to 30 minutes so that the anesthetic can take effect.
What is the purpose of a medial branch block?
The primary purpose of the medial branch block is to determine if the facet joint is the source of your pain. Though it can provide temporary pain relief, it is primarily a diagnostic procedure.
How often can you have a medial branch block?
After a medial branch block, you will most likely undergo medial branch radiofrequency ablation if indeed the facet joint is the source of your pain. Medial branch radiofrequency ablation provides long-lasting pain relief that can last for 1-2 years. This means you may not need to have another medial branch block unless radiofrequency ablation was not conducted.
What is injected during a medial branch block?
An anesthetic, usually lidocaine is what is injected during a medial branch block.
