Medial Branch Block

Facet joints are the points at which the vertebrae connect to each other. They give the spine its mobility by allowing individual vertebrae to move against each other. When these facet joints become inflamed or damaged, they can cause severe neck and back pain. Problems with the facet joints often result from spinal injuries, repetitive activities over an extended period of time, or age-related spinal deterioration. Facet joint pain can also be related to arthritis, scoliosis, spondylolisthesis, and other conditions that affect the spine. Conditions that irritate the facet joints are collectively referred to as facet joint syndrome.

The back and neck pain associated with facet joint syndrome is a result of pain signals transmitted via the medial branch nerve. Medial branch block procedures reduce this pain by injecting the affected area with local anesthetic and a steroid. The anesthetic numbs the medial branch nerve while the steroid reduces inflammation. If medial branch block injections are effective, the patient will probably also benefit from radiofrequency ablation. Radiofrequency ablation treatments provide long-term relief from facet joint pain by destroying the nerves.

Cartoon of Low Back Pain

Recovery Period

Directly after the procedure, the patient may notice a significant reduction in pain due to the effects of the local anesthesia. Once the anesthetic wears off, the pain will return and be more intense than usual for several days. The increased pain is a result of tissue damage from the needle insertion and a reaction to the steroid. After five days or so, the pain should begin to fade away. The activity of the patient may be limited for a few days due to numbness in the arms or legs. The patient should not drive directly after the procedure or for the rest of the day. Recovery time can be decreased by avoiding physical activity and applying ice packs to the affected area. The patient should be able to return to work a day or so after the procedure.

Benefits Of A Medial Branch Block

Whether or not a medial branch block has a significant effect on the patient’s pain levels, the procedure should be helpful in determining the exact cause of the pain. Feedback from the patient will determine whether his or her back pain is the result of facet joint syndrome or some other condition and the treatment plan can be refined accordingly.

Possible Risks

Medial branch block injections are typically safe, and there are rarely any side effects. Bruising and bleeding at the injection site are the most common issues. Some patients may also experience dizziness and headaches after the injections. Partial paralysis and severe allergic reactions occur in some cases, but these effects are extremely rare. Common side effects of steroid injections include flushing and increase in blood sugars. These effects should wear off after a few days.