Medial Branch Block
Queries on Medial Branch Block in Pain Clinic, Phoenix, Arizona
Facet joints are located along the back portion of the spine, and they prevent excessive twisting and bending of the lower back, as well as excessive extension of the neck. Damage to these joints occurs due to car accidents, falls, infection, arthritis, reduced disc height, and repetitive lifting of heavy objects. When these joints are damaged, it is known as facet joint syndrome or spinal arthritis. A medial branch block is a procedure that relieves pain associated with facet joint damage.
What causes spinal arthritis and facet joint syndrome?
The facet joints of the low back can carry around 15% of the body’s total weight, but when discs are narrow, the weight load increases to 65%. This leads to further damage to the facet joint cartilage lining, as well as fractures, bone spur development, and tears in the fibrous capsule of the discs. The diagnosis of facet joint syndrome is easily made with a medial branch nerve block. If the patient’s pain is eased relieved with the block, the doctor can easily make the diagnosis.
Do I need to prepare for the procedure?
The doctor will go over all your medications with you, and have you hold any blood-thinning agents a few days before procedure. Do not eat or drink at least for six hours before your scheduled appointment. As you arrive at the clinic, a nurse will go through the benefits and associated risks, if any,with you after which you would sign a form of consent. In addition, anurse will place an IV line in your arm and your blood pressure,heart rate and oxygen level will be monitored. Since mild sedation is used, you should arrange to have a ride home.
What happens during the medial branch block procedure?
You will be made to lie on your stomach on a soft table, with pillows under the abdomen and pelvis for support. An antiseptic would be used to cleanse the area and a local anesthetic would be used to numb the area of injection. Guided by fluoroscopy, a small needle would be positioned near the medial branch nerve. Then, a long-acting anesthetic is injected onto the nerve root. If the procedure provides pain relief, the doctor may inject a neurolytic agent (phenol or absolute alcohol) onto the nerve. Once done, the needle is removed and a bandage is put on the site.
What can I expect post-procedure?
You would be monitored for 20-30 minutes after the procedure in the recovery area. Your pain and function will be assessed. You are advised not to drive for at least 24 hours post discharge. Soaking in a tub or showering is not permitted for a few days. It is recommended thatyou take it easy for 1-3 days, after which you can return to routine activities.
Does the injection hurt?
Sedation is used, but it does not assure that you will not have pain. However, because a local anesthetic is used, you will likely feel just pressure and just a mild burning sensation during the injection.
What are the benefits of the medial branch block?
The medial branch block offers long-term pain relief for patients with low back pain and radiculopathy (pain in the buttocks, legs, and feet). This is a minimally invasive procedure with few risks, and it is useful for diagnosing the cause of back pain and associated symptoms.
What risks and complications are associated with the medial branch block?
Soreness at the injection site is expected, and this resolves with use of ice to the site a few times a day. This block is associated with a few risks, but they rarely occur. These include:
- Nerve injury
- Blood vessel damage
Does the medial branch block work for facet joint syndrome and back pain?
According to a recent clinical study, the medial branch block has a success rate of around 68%, with pain relief lasting for six months. The efficacy rate of combined treatment with medial branch radiofrequency neurotomy and steroid block was found to be 85%, at one month and 62% at six months.