Medial Branch Block
A medial branch block is an injection of a strong local anesthetic on the medial branch nerves that supply the facet joints. The facet joints, also known as the zygapophysial joints, are part of the bony framework of the spine. They are small bony projections from one vertebra meeting with similar bony projections from the vertebra above or below. Sometimes, due to a variety of acute and chronic conditions, the facet joints can become inflamed. For lower back (lumbar) facet joints, the pattern of pain is usually an achiness in the low back, radiating across the lower back and slightly down the back of the buttocks and upper thighs. Usually, standing or bending backward worsens the pain. For neck (cervical) facet joints, the pattern of pain is an achiness in the neck, slight radiation across the neck and shoulders, and worsening symptoms with turning the head from side to side or looking up.
Please play video for a more detailed understanding for what to expect during the procedure.
Please pay close attention to the following information/instructions:
If you are currently on antibiotics or being treated for an infection, please call the office prior to your injection appointment.
PRE-OP:
You have been scheduled for a medial branch block. This procedure is a diagnostic injection to test whether or not the facet joints along the spine are a source of your pain.
You will be receiving an injection of local anesthetic. The length of pain relief is anticipated to be 4–6 hours only. This procedure is not expected to result in long-term pain relief.
You will be asked to complete a pain diary form. This form will be given to you and explained on the day of your procedure.
We do not anticipate that you will experience any weakness or numbness in the extremities. Nevertheless, we advise that you refrain from driving the day of your procedure. Please bring a driver to your appointment, they must stay in the facility for the duration of the procedure.
MODERATE SEDATION: On the day of your appointment, we may ask you to refrain from eating or drinking 6 hours prior to your appointment time if you are receiving sedation. You may eat and drink immediately following your injection. If you take routine medications, you may take these on the day of your injection as scheduled with a small sip of water.
NO SEDATION: Please refrain from having a large meal prior to your appointment. You may have light food and/or beverages. You may eat and drink immediately following your injection. If you take routine medications, you may take these on the day of your injection as scheduled.
If you have anxiety about your scheduled office procedure and prefer to have a light sedative prescribed to take before your appointment, please notify our office at least 24 hours in advance. IV sedatives are available if your procedure is scheduled at Apex Surgical Center or Specialty Surgery Center of CNY.
If you are on any blood thinning medications (Plavix®, Coumadin®, Aggrenox®, Lovenox®, Xarelto®, aspirin), please notify our office so that we may give you specific instructions about the length of time you need to discontinue these medications.
POST-OP:
You have undergone a medial branch block procedure. This procedure is a diagnostic injection to test whether or not the facet joints along the spine are a source of your pain.
For the next 4–6 hours, your facet joints that were injected should be numb. During this time, please perform a few activities that normally cause your typical pain symptoms.
Please complete the 24-hour pain diary that you were given so that we can determine whether or not you had relief of your typical pain during the 4–6 hours following the procedure.
Fill out and bring your pain diary to your follow up appointment.
Your medial branch block may need to be repeated twice to confirm results. We will discuss this option with you in detail based on your specific situation.
In general, if your typical pain is reduced by >50%, then you are a candidate for a radiofrequency ablation. Radiofrequency ablation is a procedure that heats the medial branch nerves that supply the facet joints. By heating the individual nerves to each joint, you have the potential to experience long-term (6 months–2 years) pain relief in these joints.
Please remember that your medial branch block is only a test, and your regular pain usually returns within 24 hours.
The medial branch block treatments are relatively safe and low-risk procedure. However, some people may experience certain side effects and/or complications from this treatment. It is advised to discuss the potential risk of developing any adverse reactions or side effects of MBB with a doctor prior to this treatment.
Please feel free to make an appointment to discuss with your Doctor if you are a candidate for these services or contact one of our care representatives with questions at 315-451-5400.