Medial branch blocks can be used to treat pain in the cervical spine (neck), thoracic spine (mid-back), and lumbar spine (lower back). A medial branch block is an injection of a strong local anesthetic used to help your doctor determine the source of your back pain, as it interrupts the pain signal going from the facet joint to your brain.
The medial branch nerves are the small nerves on the facet joints that send pain signals from the facet joints to the brain. Facet joints stabilize your spine, and allow for a range of movements. Trauma, spinal stenosis, and osteoarthritis are just some of the conditions that can cause them to become inflamed.
During the procedure, a precise amount of anesthetic will be injected into the medial branch nerves; as this only takes approximately 30 minutes, you will be awake the entire time. First, your doctor will inject a local anesthetic to numb the skin and tissues around the facet joints, which will allow for a painless procedure. Most patients report feeling a burning sensation during the initial injection and then pressure during the injection into the medial nerves.
Once you are numb, your doctor will use an X-ray to locate the medial branch nerves. They will then inject a small amount of contrast dye to confirm the entire nerve will be affected. Once the needle is in place, an anesthetic will be injected into the medial branch nerves around the inflamed facet joint. Oftentimes, two medial branch nerves that are next to each other, and travel the same way to the brain, will be injected during the procedure.
Once the procedure is completed, you will rest for about 30 minutes; after which your doctor will have you move and perform any activities that would normally cause pain. If you experience immediate pain relief after the medial branch block, this will confirm that the facet joints are causing your pain. In the days after the injection, you should return to normal activities as directed by your physician.
This is not a long-term solution for pain relief. While some patients may opt to have a medial branch block up to three times a year for pain management, it is often used solely as a diagnostic tool to locate the injured facet joints. If it is successful, your doctor may recommend a medial branch radiofrequency neurotomy, which can allow for long-term pain relief.
Living with acute or chronic pain is a daily struggle, and finding relief can be challenging. The highly skilled pain doctors at the Florida Spine Institute can accurately diagnose your pain and determine the best treatment option for you.