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Medial Branch Blocks

What are Medial Branch Nerves?

medial branch blockMedial branch nerves are the small nerve branches that control sensation to part of your facet joints. The facet joint is where each bone of the spine (vertebrae) connects with the next. Each vertebra has two pairs of facet joints. These joints support your spine when you bend or twist. Each facet joint has two small medial branch nerves that carry pain signals to the brain.

What is a Medial Branch Block?

Medial branch blocks are commonly used as a diagnostic test to determine pain relief and response. The physician will only be using a small amount of an anesthetic, or numbing agent during this procedure. This is done to see if a treatment called radiofrequency neurotomy or a rhizotomy will help to relieve your pain. You will be asked to keep a pain diary for the afternoon after the injection. If you notice 70-100% pain relief after the injection, then, you will most likely be a great candidate for the rhizotomy procedure. Keep in mind that the medial branch block is diagnostic test and will only give you temporary relief. The medication is eventually absorbed into the body, so it is not unusual for your symptoms to come back again, within a few days.

How is the Medial Branch Block done?

  • Utah Spine Care uses fluoroscopy (live x-ray guidance) for all medial branch block procedures.
  • Using the fluoroscopy is key for helping the physician guide the needle to the exact position.
  • The patient will lie on a procedure bed on his or her stomach.
  • The physician will place a small pillow under the stomach of the patient to help raise the spine.
  • Your skin with be cleansed with an antiseptic solution, then the physician will inject a short-acting anesthetic (numbing agent) to the skin around the injection site.
  • Once your physician has found the correct spot, using fluoroscopy guidance, he or she will start the procedure.
  • Your Physician will direct a spinal needle into the skin and then toward the correct facet joint/medial branch
  • Once the needle has reached the correct facet joint/medial branch, the physician will inject the anesthetic (numbing agent.)

How will I feel after the injection?

Your spine pain should improve immediately after the injection from the local anesthetic (numbing agent.) A form will be given to you to keep track of your pain level throughout the rest of the day. Some tenderness may be experienced for a couple of days after the injection. Using an ice can help this. You may take your usual pain medications as well after the injection. It is important that you keep track of the amount of pain relief you received, as well as, how long the pain relief lasted. You will be scheduled in 2-3 days for a follow up appointment to review your pain relief.You will not have any restrictions after this injection; however, we ask that you do not drive for 2-3 hours afterwards. Your arms or legs may be slightly numb from the numbing agent used during the procedure. Most patients return to work the next day without limitations.