Medial Branch Nerve Block
Chronic Back Pain Treatment in Colorado
A medial branch block is a type of injection that delivers an anesthetic
to nerves in the spinal joints. This block is used to provide long-term
pain relief. At Colorado Clinic, we recommend this treatment for patients
who suffer from chronic back pains, spinal injuries, and arthritis. We
are committed to helping our patients enjoy a higher quality of life.
What are the facet joints?
The facet joints are part of the bony spinal framework. These tiny projections
are on either side of a vertebra, where the bone meets with the bone above
or below it. The facet joints can become inflamed from arthritis and spine problems.
What symptoms are associated with facet joint syndrome?
The medial branch nerves often are irritated with facet joint syndrome.
- Neck pain radiating down one shoulder and/or arm
- Lower back pain radiating down one buttock and/or leg
- Burning or aching pain
- Worsening pain with rotating the shoulder, moving the head from side-to-side,
or bending at the waist from side-to-side
How many joints/nerves are injected at one procedure setting?
The doctor may inject several medial branch nerves during once scheduled
procedure. This involves inserting small needles into the joint region
and injecting an anesthetic or neurolytic agent.
How long does a medial branch block take?
The actual injection takes only a few minutes. However, you should allow
90-120 minutes for the appointment, which includes signing forms, starting
an IV, cleaning your back, and waiting in the recovery room with the nurse
What medications are used during the medial branch block?
Solutions used during the block include:
- An antiseptic, such as Betadine
- An anesthetic, such as bupivacaine or lidocaine
- A sedative, such as Valium or Versed
- A neurolytic agent, such as phenol or alcohol
Does the medial branch block hurt?
The procedure first involves numbing the back with a local anesthetic through
a tiny needle. This may feel like a slight pinch followed by mild burning.
During the nerve injection, you may feel some pressure at the injection
site. After the procedure, expect to feel some soreness at the injection
sites. Because IV sedation is used, you will have little or no memory
of the procedure.
How is the medial branch block done?
You will first be positioned on your stomach. The nurse places an IV catheter
in your arm and attaches monitoring devices to your finger and arm. After
your back is cleaned with an antiseptic, the doctor numbs the deeper tissues
with an anesthetic. After the medication is instilled, the needle is removed.
A small bandage is placed over injection sites.
What happens after the procedure?
Because a sedative is used, you cannot drive yourself home. Arrange to
have someone take you home. We recommend resting for 1-2 days, and gradually
return to usual duties and activities. The back region will be slightly
tender, but use an ice pack for pain relief.
How many medial branch block procedures will I need?
Sometimes, several facet joints are injected at one session. Multiple levels
are blocked simultaneously, but the doctor may schedule you in for radiofrequency
lesioning if the medial branch nerve block is effective. Most patients
have pain relief immediate and then pain gradually resolves over the next
Do medial branch blocks work?
In a two-year study, researchers evaluated lumbar medial branch block efficacy.
They found that these blocks had a 93% success rate after one year, and
a 90% success rate after two years.