Medial branch nerves are small nerves that innervate the facet joints in the spine and carry pain signals from the facet joints to the brain. Facet joints are small joints at each segment of the spine that provide stability and help guide motion. The procedure is primarily diagnostic. If the patient has the appropriate duration of pain relief after the medial branch nerve block, then he or she may be a candidate for a subsequent procedure called radiofrequency ablation (RFA) for longer term pain relief. A medial branch nerve block is a procedure in which an anesthetic is injected near the small medial nerves connected to a specific facet joint. Typically, several levels of the spine are injected in one procedure. If the patient experiences marked pain relief immediately after the injection, then the facet joint is determined to be the source of the patient's pain.
Before the procedure, our staff will ask you about taking any "blood thinners" such as aspirin, Coumadin or Lovenox. These may need to be stopped prior to the injection. You should not have anything to eat or drink 8 hours prior to the injection on the day of the procedure. You should bring someone to drive you home. The procedure involves injecting a steroid/numbing medication, which can anesthetize the area and block the pain. Contrast is injected to confirm the location. A small mixture of anesthetic and steroid is then slowly injected into the joint. After the facet/medial branch block, you will be moved to the recovery area.
Benefits include having a minimally invasive procedure with minimal procedure time and pain relief in 2-3 days. Risks may include infection or hematoma at the insertion site.