Medial Branch Block Test

What are the medial branch nerves and why are medial branch blocks helpful?

Medical branch nerves are very small nerves that allow one to feel pain from the facet joints. The nerves do not control any muscles or sensation in your arms or legs. They are located along a bony groove in your low back and neck and over a bone in your mid-back.

There is strong evidence to suspect that your facet joints are the source of your pain. Therefore, you may benefit from having the small medial branch nerves and their pain signals interrupted via a controlled non-surgical heat lesion produced by a special needle.

Before interrupting these nerves and their pain signal, we first block the medial branch nerve signals with numbing medicine as a test. This tells us whether or not you are likely to benefit from having the medial branch nerves interrupted at a later date by the special radiofrequency needle. This more permanent treatment is called radiofrequency medial branch neurotomy.

What will happen to me during the procedure?

An IV will be started so that relaxation medicine can be given, if needed. After lying on an X-ray table, the skin over the area to be tested will be well cleansed. Next, the physician will numb a small area of skin with numbing medicine (anesthetic) which stings for a few second. Next, the physician will use X-ray guidance to direct a very small needle over the medial branch nerves.  He/she will then inject several drops of contrast dye to confirm that the medicine only goes over these medial branch nerves. A small mixture of numbing medicine (anesthetic) and possibly anti-inflammatory cortisone will then be slowly injected.

What should I do and expect after the procedure?

You will report your remaining pain (if any) and also record the relief you experience during the next 3-4 days. You may or may not obtain improvement in the first few hours after the injection depending upon if the medial branch nerves that were injected are carrying pain signals from your spinal joins to your brain.

On occasion, your neck/back may feel numb or have an odd feeling for a few hours after the injection. You may notice a slight increase in your pain lasting for several days as the numbing medicine wears off. Ice will typically be more helpful than heat in the first 2-3 days after the injection. Although, the main purpose of this procedure is as a test to see whether you would benefit from a subsequent medial branch neurotomy, on occasion, long term-relief can occur from the cortisone that was injected over these nerves. If this occurs, it is usually within 3-7 days after the procedure. You may take your regular medicine after the procedure, but try to limit your pain medicines the first 6 hours after the procedure so that diagnostic information obtained is accurate.

Cervical & Lumboscacral Medial Branch Block

What are the medial branch nerves and why are medial branch block helpful?

Medial branch nerves are the very small nerves that allow one to feel pain from the facet joints. The nerves do not control any muscles or sensation in your arms or legs. They are located along a bony groove in your low back and neck and over a bone in your mid-back.

There is strong evidence to suspect that your facet joints are the source of your pain. Therefore, you may benefit from having the small medial branch nerves and their pain signals interrupted via a controlled non-surgical heat lesion produced by a special needle.

Before interrupting these nerves and their pain signals, we first block the medial branch nerve signals with numbing medicine as a test. This tells us whether or not you are likely to benefit from having the medial branch nerves interrupted at a later date by the special radiofrequency needle. This more permanent treatment is called radiofrequency medial branch neurotomy.

What will happen to me during this procedure?

An IV will be started so that relaxation medicine can be given, if needed.  After lying on an X-ray table, the skin over the area to be tested will be well cleansed. Next, the physician will numb a small area of skin with numbing medicine (anesthetic) which stings for a few seconds. Next, the physician will use X-ray guidance to direct a very small needle over the medial branch nerves. The physician will then inject several drops of contrast die to confirm that the medicine only goes over these medial branch nerves. A small mixture of numbing medicine (anesthetic) and possibly anti-inflammatory cortisone will then be slowly injected.

What should I do and expect after the procedure?

You will report your remaining pain (if any) and also record the relief you experience during the next 3-4 days. You may or may not obtain improvement in the first few hours after the injection depending upon if the medial branch nerves that were injected are carrying pain signals from your spinal joints to your brain.

On occasion, you neck/back may feel numb or have an odd feeling for a few hours after the injection. You may notice a slight increase in your pain lasting for several days as the numbing medicine wears off.  Ice will typically be more helpful than heat in the first 2-3 days after the injection. Although the main purpose of this procedure is as a test to see whether you would benefit from a subsequent medial branch neurotomy, on occasion, long-term relief can occur from the cortisone that was injected over these nerves. If this occurs, it is usually with 3-7 days after the procedure. You may take your regular medicines after the procedure, but try to limit your pain medicines the first 6 hours after the procedure so that the diagnostic information obtained is accurate.