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Medial Branch Nerve Blocks

Outpatient procedure for diagnosing and treatment of headaches, neck pain, back pain and muscle spasms

Medial Branch Block Injection Facts and Information

Medial Branch nerves extend out from the facet joints in the spine and carry pain signals from these joints to the brain. A medial branch nerve block stops the transmission of pain signals from the sensory nerve of the inflamed facet joint. A local anesthetic (numbing medicine) and corticosteroid (anti-inflammatory medicine) are injected around one or more of your medial branch nerves. If your pain improves after the injection, it will inform the physician which medial branch is the pain generator. Depending on where you are experiencing your pain, this injection will take place in one or more of the four regions of the spinal column: Cervical, Thoracic, Lumbar or Sacrum. This injection is used to diagnose and treat headaches, neck pain and back pain resulting in painful spasms.

About the Medial Branch Block Procedure

The procedure begins with the patient lying on an x-ray table, the skin will be treated with local anesthetic. Using live X-ray guidance (fluoroscopy), a needle is directed next to the medial branch nerve. Contrast dye is used to ensure proper needle placement. Then, a small amount of medication will be injected around each targeted nerve.

After the Medial Branch Block Procedure

You will be monitored for up to 30 minutes after the injection. When you are ready to leave, the staff will give you discharge instructions and a pain diary. Please fill this diary out because it informs the doctor how much improvement you obtained after the procedure. Patients are requested to provoke their painful region. You may or may not experience immediate pain relief after the procedure. This is dependent on which medial branch nerves are responsible for your pain syndrome and if they were blocked on the day of the procedure. The pain may return after a short pain-free period. It may even be a little worse for a day or two. The Corticosteroids usually take two or three days to start working. You can return to work the day after the injection.

How long can I expect pain relief from a branch block?

The extent and duration of pain relief may depend on the amount of inflammation and how many areas are involved. Sometimes one injection will bring long term pain relief, several weeks to months. If the pain returns more treat may be needed. If your pain is caused by an injury to more than one area, only some of your symptoms may improve.

How long does a branch block procedure take?

Medial branch blocks are performed on an outpatient basis. The procedure typically requires 20 to 30 minutes, including preparation time.

How often should this procedure be done?

Up to three injections may be given within a six-month period. Usually each injection are two to three weeks apart. A set of three injections may be needed, however you may gain considerable pain relief after the first or second injection. In this instance, further injections may not be necessary.

What are the alternatives?

Conservative treatment (e.g. physical therapy, exercise regimens and nonsteroidal anti-inflammatory medications) is often prescribed first. Surgery may be a possible alternative, however these procedures may only provide temporary pain relief. This procedure can help determine if surgery would be beneficial by more precisely localizing the source of your symptoms.

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