FAQs on Medial Branch Block

Medial Branch Block San DiegoThe small nerve endings that “branch off” from other nerve roots are called medial branches; these nerve endings encircle the spine to the facet joints, and serve to transmit sensation to these.

The Medial Branch Block is a procedure in which a mixture of local anesthetic and steroids that act as long acting pain relieving drugs are injected into the area of a specific facet joint of the spine in order to effectually numb the Medial branch nerve associated with that specific facet joint. This is used either as a therapeutic procedure in itself, or as a diagnostic procedure to determine the patients need for further procedures.

What is the goal when a patient gets Medial Branch Block injections?

The long term goal of the Medial Branch Block procedure is to relieve chronic pain, but initially it may be used to diagnose a patient to determine candidacy for a procedure called a Medial branch radiofrequency neurotomy (or ablation). If the patient experiences appropriate pain relief from the injection they may be given the medial branch radiofrequency neurotomy to provide the patient with long term relief from chronic pain.

How is the Medial Branch Block procedure performed?

Medial Branch Nerve Block The Medial Branch Block procedure is performed as an outpatient procedure. The patient is placed face down on the table and the area to be injected is cleansed and a topical anesthetic is used to ease the sensation of a needle being inserted, an IV may be administered for patients receiving injections in the neck.

A local anesthetic is given and then needles are placed into the area to be injected with drugs with the aid of a device called a fluoroscope (x-ray machine). Fluoroscopy (multiple X-rays taken quickly to show a real-time image will be used to ensure accurate placement of the needle within the body. Dye is usually injected first to determine correct placement of the needles. A number of injections will be made to address each medial branch, as the branches encircle the spine both above and below each facet joint. After the injection is completed a small bandage will be placed over the injection site.

 How long do the injections last?

Relief provided by the procedure varies with each patient. Some relief is generally felt by everyone but some may benefit more than others. Patients may experience immediate relief from the local anesthetic but this is short acting. The steroid may take several days to take full effect. During this time patients may experience increased pain or discomfort in the injection location. Patients that do experience significant relief are candidates for the Medial branch radiofrequency neurotomy procedure which will provide long term pain relief without repeated procedures.

What are the risks or side effects of the Medial Branch BlockMedial Branch Nerve Block procedure?

As with any medical procedure there are some risks involved. Patients are likely to experience slight bruising or minor bleeding at the injection site, but less commonly the patient could experience allergic reaction to the drugs, weakness or numbness, or nerve damage. Diabetics may experience short term elevated blood sugar levels.

What conditions are treatable with the Medial Branch Block?

The Medial Branch Block procedure is typically given to patients with chronic back pain caused by conditions such as arthritis, or pain caused by injury to the spine or intervertebral disc.

How successful is a Medial Branch Block for the relief of pain?

Most patients will experience relief from Medial Branch Block injections but the level of relief varies from person to person. They are a reliable outpatient procedure with very little risk to the patient, with very low chance of side-effects.