Medial Branch Nerve Block Injections

A medial branch nerve block refers to the use of a local anesthetic medication (injected into the suspected pain-generating site) to numb the medial branch nerves. A medial branch nerve block temporarily stops the transmission of pain signals from the facet joints to the brain.

Having a medial branch nerve block with a local anesthetic may help determine if long-term pain relief can be achieved with a more permanent way of blocking these nerves using procedures like a radiofrequency nerve ablation.

So, the goal of the medial branch block is to relieve back pain, which is thought to be caused by nerves that supply facet joints.

What are medial branch blocks?

During a medial branch block, a doctor delivers anesthetic to the medial branch nerves responsible for the low back.

These regions become the source of pain if they are inflamed. The pain can worsen with certain movements, such as bending or radiating into other parts.

A medial branch block targets determining the source of back pain. If the pain wasn’t relieved by providing anesthetic to a particular region, it wasn’t caused by these nerves.

Because of its pain-relieving properties, this procedure can be considered both a diagnosis and treatment for back pain.

The duration of pain relief varies between individuals. It can last from several days to several months. If the procedure was highly effective and removed the pain, the specialist can determine the nerves causing the pain. Such information can influence the following treatment course.

The procedure is performed in an x-ray room while a patient is lying on a stomach. The skin area is anesthetized with a local anesthetic. At this point, there can be a burning sensation. After this, a specialist advances needles to targeted locations using x-ray guidance.

The needles then inject a local anesthetic that can be mixed with steroids.

After the procedure, the patient is taken to the recovery area in the hospital, where a nurse checks blood pressure and pulse. Usually, you can go home about an hour after the procedure. But it is not advised to drive yourself.

Medial branch blocks risks

You should know that this procedure shouldn’t be performed if a patient has an active infection, such as flu, cold, high blood pressure, fever, etc. Also, it can be recommended to avoid it if you take blood-thinning medications.

Among the procedure’s risks are excessive bleeding, infection, nerve injury, and allergic reaction to medications used.

The most common side effects are unpleasant sensations, such as numbness or weakness, that last several hours after the procedure. Also, usually, pain can increase after a medial branch block, especially in the region targeted by the procedure.

If steroids were used, a patient could have diarrhea and abdominal pain, flushing, or redness to the face.

Usually, the side effects go away after a while, from a couple of hours to a week after the procedure.

How to prepare for the lumbar medial branch block procedure?

Your medical team will give you a proper preparation plan for the procedure. But, there are general points which we’ll cover.

Firstly, the medical team will assess whether performing the procedure is safe. For example, the procedure is not recommended for pregnant women, people with diabetes, or people who tested positive for MRSA.

Generally, before the procedure, you should continue to take your regular medications, including pain-relieving ones. But in some cases, you can be advised otherwise. Before the procedure, you can prepare comfortable clothes, such as a dressing gown, and some reading or watching materials to spend time while waiting for the procedure. Also, you should ensure that you arrange a transfer from the hospital beforehand; for example, you ask your relative or friend to pick you up. It is advised not to drive after the procedure, so keep this in mind.

You shouldn’t eat in the morning before your procedure if sedation is involved. You can have a drink, however.


Normal Medial Branch Nerve


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