Patients who suffer from lower back pain due to inflamed facet joints, could potentially benefit from a medial branch block.
A medial branch block is an injection of a strong local anesthetic on the medial nerves which supply the facet joints. Acute or chronic conditions can inflame the facet joints, resulting in achiness in the lower back, which can also travel down the back of the buttocks and upper thighs. Standing or bending backwards, even a little, usually exacerbates the pain. In the cervical facet joints the pain pattern tends to be an achy neck, with the pain radiating across the neck and shoulders. This pain intensifies when the head is turned from side to side or tilted upward.
Medial Branch Block Procedure
A medial branch block is generally considered a low-risk procedure, and is typically done in office. The procedure is considered diagnostic, rather than therapeutic—in other words, your response to the medial branch block will help determine the best pain relief solution for you. You will receive a local anesthetic at the injection site, which usually feels like a small pinch, then a slight burning feeling as the anesthetic begins to numb the skin.
You will probably be asked to lie on your stomach for a medial branch block in your back, or on your side for a neck injection. A very small needle will be placed into the medial branch nerve location, and a small amount of anesthesia or, sometimes, a corticosteroid medication, will be injected along each nerve. Depending on how many joints are involved, you may require multiple injections.
Potential Risks and Complications of a Medial Branch Block Procedure
While a medial branch block is considered a safe procedure, there are certain complications—although rare—which could occur, including:
- Allergic reactions to the anesthetic or the x-ray contrast solution
- Bleeding (more common in those with bleeding disorders)
- Worsening of pain symptoms
- Nerve or spinal cord damage
- Injection site discomfort
- Numbness or weakness in the neck or back for a few hours following the injection
What Will Your Doctor Learn from the Results of Your Medial Branch Block?
If the medial branch block was able to accurately target the medial branch nerves for the joint causing the pain, then immediate pain relief may be felt. You will likely be asked to record the levels of pain relief you receive during the first few hours following the procedure. Depending on how well your pain is relieved in the first 4-6 hours following the medial branch block, you may be a candidate for radiofrequency ablation, which can provide longer-term pain relief. You should definitely expect your normal pain levels to return when the anesthetic wears off.
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