Medial Branch Blocks for Back Pain

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Your medial branch nerves supply the facet joints, which are located between each vertebra in your spine. Facet syndrome occurs when one or more of these facet joints are irritated or inflamed. This condition can cause aching in the lower back or in the neck, depending on which joints in the spine are infected. The pain can radiate to other areas and worsen with standing or bending backward.

Medial branch blocks disrupt the pain signals that are sent from the medial branch nerves, which can act as long-term relief or a diagnostic tool. If the medial branch nerves confirm that the facet joints are the cause of pain, a radiofrequency neurotomy of the medial branch nerves may be performed.

How it’s Administered

Medial branch nerves consist of steroid and an anesthetic. The injection is administered with fluoroscopy x-ray guidance so that the needle can be precisely placed. Medial branch blocks take approximately 30 minutes, including preparation time.

Typically, only three injections are administered in a six-month time period. However, most patients only need one or two injections to experience relief or to demonstrate that radiofrequency neurotomy would be effective.

What to Expect

You will experience relief several minutes after the injection, and the relief will last for a few days. This relief is a result of the anesthetic in the injection. More long-term relief comes a few days after the injection and is due to the steroid.

Patients who receive medial branch blocks are advised to take it easy for a day or so, and to pay attention to the activities that you can tolerate without discomfort. In most situations, you should be able to return to work right away.

There are very few risks associated with medial branch blocks. The injection is not recommended for patients with known allergy to the anesthetic or steroid in the injection, or for patients who are on blood thinning medications. Your doctor can help you determine if medial branch blocks are a good next step for the discomfort that you are experiencing.