FAQs on Medial Branch Block in Atlanta

Facet joints are the tiny joints of the spine that support the structure and aid in bending and rotation of the back. Facet joint pain can occur when these joints become inflamed from injury or arthritis.

When facet joints are irritated in the neck (cervical spine) region, the pain may radiate into the upper back, shoulders, and head. When the lower back facet joints (lumbar spine) are irritated, the pain can radiate into the hips, buttocks, and thighs.

Why is a medial branch block done?

A medial branch block is a diagnostic injection, used to assess and determine the cause of your pain. This block provides only short-term pain relief. This procedure is often done twice, with several days in between injections. The first block involves the use of a local anesthetic injected into the space to block the medial branch nerve. The second procedure involves the use of a long-acting anesthetic.

Where are the medial nerves located?

The cervical (neck) medial branch nerves are located in a bony groove in the neck. The thoracic medial branch nerves are located over the bone in the upper back. The lumbosacral medial branch nerves are positioned in a bony groove of the lower back.

What can I expect before the medial branch block?

You will arrive at the procedure center approximately 1 hour before the scheduled procedure. A staff member will go over the procedure and have you sign a consent form. One of the nurses will insert an IV catheter into your arm and attach monitoring devices to you to check vital signs.

How will the medial branch block procedures be performed?

A medial branch block is much like the facet joint injection except the medication is instilled outside the joint space near the medial branch nerve that supplies the facet joint. You are positioned on your stomach, and the skin is cleansed with an antiseptic.

The needle(s) is/are inserted using x-ray guidance (fluoroscopy), so the doctor can determine the precise location that needs blocked. Once the medication is placed near the nerve, the needle is removed, and a bandage is applied.

Will radiofrequency energy be used?

When the medial branch nerve block confirms that the pain originates from a facet joint, a radiofrequency neurotomy may be done for longer pain relief. This involves the use of radiofrequency energy and heat to destroy the nerve that transmits pain to the brain. The goal of a radiofrequency neurotomy is to stop the pain signal to the brain while preserving muscle strength and sensation.

What can I expect after the procedure?

You will be given discharge instructions when you leave the recovery area. This sheet provides you will information regarding side effects, complications, and restrictions. You will be advised when to return for your follow-up visit. You are not allowed to use heat on the injected area for the remainder of the day, and you should avoid soaking in water or swimming afterwards.

What are the risks and complications of the medial branch block procedures?

As with any minimally invasive procedure, there are risks and complications associated with the medial branch block. There is a remote risk of infection, bleeding, nerve injury, allergic reaction, or vessel damage. Short-term side effects include weakness or numbness of the arms/legs for several hours after the procedure. In addition, some patients experience localized pain at the injection site.

Does the medial branch block work?

In a clinical study of lumbar medial branch blocks involving more than 100 patients, the efficacy rate was found to be 84%. In addition, most of the participants reported improvement at a 2-year follow-up. In a separate study, patients reported more than 50% pain relief and significant functional improvement at 3, 6, and 12 months.