Conditions Treated

Your facet joints come in two pairs, each connecting vertebrae above and below. These joints give our spine stability while still allowing it to twist and flex, moving us through our everyday life. Facet joints exist at every level of the spine, from the tailbone to the neck. If the facet joints are injured or inflamed, they begin to press on the medial branch nerves, causing pain and limiting movement.

As noted, medial branch blocks are an excellent diagnostic tool, providing nearly instant information to your doctor. In addition, medial branch blocks can treat the following three types of chronic pain.

1. Neck pain

Starting at the top of the spine, medial branch blocks can help relieve chronic neck pain in the cervical spine. Neck pain occurs for a variety of reasons, including disease and injury.

Your cervical spine consists of six vertebrae connected to each other by the facet joints for both support and movement. When these joints are painfully inflamed due to injury or other conditions, a medial branch block relieves your pain so you can work on strengthening and rehabilitating the cause of your neck pain.

2. Back pain

Lower back pain is the most common kind of back pain. Every vertebra in your lumbar spine has facet joints and can be treated with a medial branch block.

In many cases, this type of injection helps where other injections may not have offered relief. Medial branch blocks are also frequently used as a diagnostic tool to determine the cause of your lower back pain.

3. Facial pain

Facial pain can also be relieved by medial branch blocks.

This may help with severely painful conditions, like chronic headache or trigeminal neuralgia.

Benefits

One of the most obvious medial branch block benefits is pain relief. Many patients feel nearly instantaneous pain relief with this injection. This relief can last for several months.

As a diagnostic tool, medial branch blocks are useful for hard-to-diagnose and treat conditions, such as trigeminal neuralgia or chronic lower back pain. If a medial branch block successfully treats that pain, it alerts your doctor that other nerve pain treatments, like radiofrequency ablation, can offer even longer-lasting relief.

A final medial branch block benefit is that the injection can be offered steroid-free. This eliminates the potential risks of long-term steroid use while still offering pain relief.

Procedure

The medial branch block procedure takes about an hour from start to finish, though the injection itself only takes a few minutes.

After you position yourself face down on the examining table, your doctor will clean and sterilize the injection area. They will administer a topical anesthetic and then inject a local anesthetic to ease the pain of the injection itself. In general, the medial branch block procedure is not painful, except for a little pinch when the local anesthetic is injected. Talk to your doctor if you have concerns. If you are anxious or worried about pain, they may offer you light sedation.

Once the area is numb, your doctor uses fluoroscopy (a type of X-ray) to guide the injection to the proper facet joint. Your doctor will first inject colored dye over the medial branch nerves. This is another way to check that the needle is properly positioned. When the placement is confirmed, the medication is injected.

Your doctor will monitor your initial response to the treatment. It is important to note that pain relief timing will vary. Some patients feel immediate pain relief. Others experience a brief increase in pain before they find relief. Still, others may not have any pain relief, indicating a different source of pain.

For the majority of patients with facet joint pain, medial branch blocks relieve pain and can be administered no more than six times per year. If your doctor is using the medial branch block as a diagnostic tool, four times per year is more appropriate.

Recovery

Medial branch block recovery is usually swift, but your recovery time might vary. Take it easy on the day of your procedure. Have a friend or family member give you a ride home.

If you have minor soreness at the injection site, talk to your doctor about over-the-counter pain medications. You can also apply an ice pack to relieve swelling. You should be able to resume your normal activities within a day or so, but check with your doctor for recovery instructions that are specific for you.

Risks

Although they are generally recognized as safe, there are medial branch block side effects to be aware of. Soreness and minor bleeding at the injection site is common but usually brief, lasting only a few days.

More serious medial branch block side risks include:

• Infection
• Allergic reaction to the medication
• Headaches