Cervical medial branch blocks are an effective way to treat chronic neck pain. Done in a simple outpatient procedure, the cervical medial branch blocks procedure can offer pain relief when other conservative treatments have failed. When you are ready to get back to pain-free living, get in touch with The Pain Experts of Arizona. We can help you feel better! Curious about what happens in a cervical medial branch block procedure? Check out the video below or continue reading.
Cervical medial branch blocks are used in two ways: as a treatment for chronic neck pain and as a diagnostic tool.
Your medial nerves send sensory information from both sides of the facet joints to the brain. The facet joints are located on the back of the spine between each vertebra. These joints allow for movement with stability. They also get plenty of wear as we move about our day.
When the facet joints suffer from trauma, injury, repetitive stress, or disease, the medial branch nerves can send pain signals to the brain. Pain that originates in the cervical spine may be felt in the neck, shoulders, upper back, and head.
Neck pain conditions treated with medial branch blocks include the following:
If the pain signals from these conditions are blocked successfully, other treatments can help you heal. For example, in some cases, cervical medical branch blocks allow you to pursue physical therapy to treat an underlying condition. Your doctor may also use cervical medial branch blocks as a diagnostic tool before proceeding with more permanent pain relief options, like cervical radiofrequency ablation.
Cervical medial branch blocks benefits go beyond pain relief. Your doctor can use a cervical medical branch block to diagnose the underlying cause of your neck pain, too. Getting a proper diagnosis of your pain’s cause is critical for proper treatment.
Other cervical medial branch blocks benefits include:
The procedure is minimally invasive
It can allow you to avoid more invasive surgeries
Pain relief is long-lasting
The block can be repeated
Side effects and risks are rare
A double-blind study of cervical medial branch blocks for chronic facet joint pain found significant pain relief and improved quality of life in more than 83% of study participants. For patients who require surgery for their neck pain, a postoperative cervical medial branch block offers pain relief during recovery, too.
Finally, chronic pain is expensive. A 2017 cost-utility analysis found that cervical medial branch blocks offered a better quality of life over a longer period of time for the same cost as other less successful interventions. For many patients, this minimally invasive procedure provides an affordable alternative to surgery.
The cervical medial branch blocks procedure is an outpatient procedure. It takes about 90 minutes from the moment you walk in the door to the time you leave.
To begin, you position yourself on your stomach on the exam table. Your doctor cleans and sterilizes the area to be injected. Because your comfort is important, your doctor uses topical numbing medication and then an injected local anesthetic. This makes the procedure more comfortable. If you are concerned about pain during your procedure, ask your doctor about a mild sedative that you can take beforehand.
Using X-ray (fluoroscopic) guidance, your doctor uses a small needle to inject contrast dye over the targeted medial branch nerve. This helps to ensure that the injected medication is properly placed. Once the location is confirmed, your doctor injects numbing anesthetic over the medial branch nerves. For best results, two or more adjacent medial branch nerves are injected in the procedure.
Some patients experience immediate, profound pain relief. For others, pain relief takes longer—up to six hours after the injection. If pain is relieved by at least 80% in six hours, the cervical medial branch block is deemed successful.
The duration of pain relief can vary, too. Some patients experience pain relief that lasts for months or years. Others feel better for just days or hours. Results are individual and depend on a variety of factors.
You will need someone to drive you home on the day of your procedure. Plan to take the remainder of the day off to rest. After the local anesthetic wears off, you might experience some soreness at the injection site. Apply ice to treat any swelling, and ask your doctor about taking an over-the-counter, non-steroidal anti-inflammatory (e.g., ibuprofen) for any minor pain.
Do not take any prescription pain medication until directed by your doctor. Taking prescription pain medication will make it hard to determine what has relieved pain—the cervical medial branch block or that medication.
Generally, you can return to your normal activities the day following the procedure. Talk to your doctor about any specific cervical medial branch block recovery instructions before resuming vigorous exercise or activity. Most patients have a short recovery period, though.
All medical procedures come with a certain level of risk. Cervical medial branch blocks side effects and risks are low, but it’s important to be aware of those that do exist.
Cervical medial branch blocks risks include:
Pain or discomfort at the injection site
Allergy to the anesthetic
Bleeding (most often in patients with bleeding disorders)
Increase in pain
Minor infection may occur in fewer than 2% of patients (major infections are practically non-existent at fewer than .1%). Rarer still is the risk of damage to the spinal cord. This might occur due to injury with the needle or severe infection.
Always work with a doctor who has extensive experience in this pain management approach to minimize the risk of side effects. Also discuss your current medication use, such as blood thinners, or conditions that could increase your risk.