FAQs on Medial Branch Block in Nashville TN

A medial branch block is an injection of a long-acting local anesthetic onto the medial branch nerves that supply the facet joints (also called zygopophysial joints). These joints are part of the bony framework of the spine, and they become inflamed from a variety of acute and chronic conditions. The cervical medial branch nerves are located in the neck, the thoracic medial branch nerves are located in the upper back, and the lumbar medial branch nerves are located in the lower back.

What conditions are treated with a medial branch block?

The medial branch block is used to diagnose and treat facet joint syndrome and spinal arthritis. Facet joint syndrome is a condition associated with achiness in the lower back, which radiates down the lower back into the buttocks and thighs. Standing and bending often makes the pain worse. For cervical facet joint pain, the pattern of pain is associated with achiness of the neck, which can radiate across the neck, shoulders, and arms. These symptoms are often worsened with head turning and movement.

What can I expect before the medial branch block?

Before the medial branch block, the doctor will conduct several diagnostic tests to decide which treatment option is best for you. Once deciding on the procedure, the doctor will discuss the risks and benefits with you and have you sign a consent form. When you arrive at the medical center, a nurse will insert an IV catheter into your arm and attach monitoring devices to assess vital signs.

How is the medial branch block procedure performed?

The doctor will position you on your stomach, and cleanse the skin of the back with an antiseptic solution. Using x-ray guidance, a needle is positioned near the medial branch nerves. Once position is confirmed, the medication is injected onto the nerves and the needle is removed. If the block confirms pain originates from a facet joint, the doctor may choose to perform a radiofrequency neurotomy for long-term pain relief.

What can I expect after the procedure?

After the medial branch block procedure, you will be moved to a recovery area where a nurse will monitor your condition for 20-30 minutes. You are not allowed to apply heat to the injected site for the rest of the day, and should avoid soaking in the tub or swimming afterwards. You will be given discharge instructions regarding complications, risks, and side effects.

What are the benefits of the medial branch block?

The success rate of the medial branch block is approximately 85%, according to clinical studies. However, efficacy rates vary from patient to patient. In a recent clinical study, most patients reported some level of pain relief within 6-12 hours of the procedure. In addition, most patients reported more than 50% improvement in functional ability and pain relief at 3, 6, and 12 months.

What are the side effects, risks, and complications of the medial branch block procedure?

Side effects to the medial branch block include pain at the injection site, leg/arm weakness, and low blood pressure. These symptoms usually are temporary and resolve within a few hours. As with any minimally invasive procedure, there are risks and complications associated with the medial branch block. These include risk of infection, nerve injury, allergic reaction to medications or contrast dye, bleeding, and vessel damage.

Resources

Manchikanti, L, Singh, V, Falco, FJE, Cash, KA, et al. (2012). The role of thoracic medial branch blocks in managing chronic mid and upper back pain: A randomized, double-blind, active-control trial with a 2-year rollowup. Anesthesiology Research and Practice, Article ID 585806. http://dx.doi.org/10.1155/2012/585806

Manchikanti, L, Manchikant, KN, Damron, KS, & Pampati, V (2004). Effectiveness of cervical medial branch blocks in chronic neck pain: a prospective outcome study. Pain Physician, 7(2), 195-201.

Shim JK, Moon JC, Yoon KB, Kim WO, & Yoon DM (2006). Ultrasound-guided lumbar medial-branch block: a clinical study with fluoroscopy control. Reg Anesth Pain Med, 31:451-454.