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Medial Branch Block

Overview

Medial Branch Block

Medial branch nerves are the very small nerve branches that communicate pain caused by the facet joints in the spine. These nerves do not control any muscles or sensation in the arms or legs. They are located along a bony groove in the low back and neck and over a bone in the mid back. The purpose of this procedure is to determine if the facet joints are painful. There is no other test that gives this information. CT Scans and MRI scans will not tell if the facet joints are painful. This test is only temporary, but if it shows the joints to be painful, a long-term procedure, radiofrequency lesioning, can be performed.

Medial Branch Block

Procedure Details

Will you be asleep for the procedure? It is not necessary for you to go to sleep for this procedure; however, you will receive enough medication to keep you comfortable. How long will the procedure take? Normally, a medial branch block takes about 15 to 30 minutes. The session can take longer if you are having more than one injection.

Procedure Overview

An IV will be started, if necessary, to provide relaxation medication. The patient is placed on the x- ray table and positioned in such a way that the physician, using x-ray guidance, can best visualize the bony areas where the medial branch nerves pass. The skin is scrubbed with prep solution. Next, the physician numbs a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has had time to take effect, the physician uses x-ray guidance to direct a very small needle near the specific nerve being tested. A small amount of contrast (dye) is injected to ensure proper needle position. Then, a small amount of numbing medicine (anesthetic) is injected. This generally does not provoke a patient’s usual pain like the joint injections may have.