What Is a “Medial Branch Block”?

Medial Branch Blocks, commonly called Facet Blocks, are diagnostic procedures used to identify the source of lumbar or back pain emanating from the facet joints. These joints, positioned along the spinal column and connecting each vertebra, can be sources of localized, non-radiating pain when problematic.

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Understanding the Facet Joints and How Medial Branch Blocks Help

Facet joints are small, stabilizing joints between and behind adjacent vertebrae in the spine. These joints provide flexibility and stability to the spine, allowing for smooth movements such as bending and twisting. However, like any other joint, facet joints can become a source of pain due to arthritis, injury, or degeneration. When these joints become inflamed or damaged, they can lead to localized, non-radiating back pain that significantly impacts daily activities.

Medial Branch Blocks (MBBs) are diagnostic procedures designed to determine whether the facet joints are the source of this pain. By injecting a small amount of anesthetic around the medial branch nerves—nerves that transmit pain signals from the facet joints to the brain—the procedure temporarily blocks these signals. If the pain relief is significant, it confirms that the facet joints are the likely source of the discomfort, guiding further treatment options. This targeted approach allows physicians to accurately diagnose and potentially treat facet joint pain, offering patients a path toward more effective pain management.

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What Is The Medial Branch Block Procedure?​

The process begins with the patient lying face down. The skin is sterilized with an antiseptic solution, followed by applying a local anesthetic to numb the area. A needle is placed near the lumbar medial branch nerves, using fluoroscopic guidance for precision. A small amount of anesthetic is administered around the nerve, temporarily interrupting the pain signals and helping to pinpoint the pain’s origin. The procedure is swift, typically taking 5 to 10 minutes, and many patients experience immediate relief.

The primary goal of the MBB is diagnostic. By providing temporary relief, it helps confirm whether the facet joints are the pain source.

If the block is effective, it indicates that Radiofrequency Ablation (RFA) may be beneficial for longer-term pain management.

If the MBB indicates that the facet joints are the pain source, the next step may be an RFA. This advanced procedure uses heat to disrupt pain signals from the affected nerves. It’s minimally invasive and can offer sustained relief for those with arthritis-related pain in the neck, mid-back, or lower back.

Pre-Op and Post-Op Instructions

PRE-OP

  • Arrange for transportation if your doctor does not recommend driving immediately after the procedure.
  • Discuss all current medications with the doctor, especially blood thinners, which might need to be paused.

POST-OP

  • Rest the treated joint and avoid strenuous activities for at least 24 to 48 hours.
  • Apply ice if there’s minor swelling or discomfort.
  • Avoid activities like swimming or saunas for the next 24 to 48 hours.
  • Watch for any signs of infection or adverse reactions and inform the clinic if these occur.
  • Schedule a follow-up appointment to assess your progress and determine if additional treatments or injections are necessary.

Discover if a Medial Branch Block is the right solution for your chronic pain. For expert guidance and a personalized treatment plan, contact the Advanced Relief Institute to schedule your appointment today.

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Medial Branch Blocks FAQ

Who is a candidate for a Medial Branch Block?

What are the risks and side effects of a Medial Branch Block?

How long does the relief from a Medial Branch Block last?

How often can the Medial Branch Block procedure be repeated?

Is the Medial Branch Block procedure painful?

How does a Medial Branch Block compare to other diagnostic and treatment options?

Who is a candidate for a Medial Branch Block?

Medial Branch Blocks are typically recommended for individuals experiencing chronic back pain that has not responded well to conservative treatments such as physical therapy, medications, or lifestyle modifications. Ideal candidates are those whose pain is suspected to originate from the facet joints. The procedure is most commonly used for patients with arthritis-related neck, mid-back, or lower back pain. A thorough evaluation by your physician will determine if a Medial Branch Block is appropriate for your condition.

What are the risks and side effects of a Medial Branch Block?

Medial Branch Blocks are generally safe, but as with any medical procedure, there are potential risks and side effects. Common side effects include temporary soreness or discomfort at the injection site, mild bruising, or a slight pain increase before relief. In rare cases, patients may experience an allergic reaction to the anesthetic or an infection at the injection site. Discussing these risks with your physician before the procedure ensures you are well-informed and prepared.

How long does the relief from a Medial Branch Block last?

The relief from a Medial Branch Block is typically temporary, lasting only a few hours to a few days. The primary goal of the procedure is diagnostic—to determine if the facet joints are the source of your pain. If significant relief is achieved, your physician may recommend further treatment options, such as Radiofrequency Ablation (RFA), which can provide longer-lasting relief.

How often can the Medial Branch Block procedure be repeated?

Medial Branch Blocks can be repeated, particularly if the initial block provides significant diagnostic information or temporary relief. However, they are usually performed as a precursor to more definitive treatments like Radiofrequency Ablation. Your physician will guide you on the appropriate timing and frequency of repeat procedures based on your case.

Is the Medial Branch Block procedure painful?

The Medial Branch Block procedure is generally well-tolerated by most patients. A local anesthetic is used to numb the area before the injection, which helps to minimize discomfort. You may feel a brief pinch or pressure as the needle is inserted, but the procedure is quick, typically taking only 5 to 10 minutes. Most patients report minimal pain during and after the procedure.

How does a Medial Branch Block compare to other diagnostic and treatment options?

Medial Branch Blocks are primarily diagnostic, helping to pinpoint the exact source of back pain by temporarily blocking pain signals from the facet joints. This targeted approach allows for more accurate diagnosis than general pain relief methods like oral medications. If the block is effective, it may lead to treatments such as Radiofrequency Ablation, which can provide longer-lasting relief. Compared to more invasive surgical options, Medial Branch Blocks are minimally invasive and offer a quick recovery, making them an attractive option for patients seeking to avoid surgery.

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