Medial Branch Block
What is it?
A medial branch block is a procedure used to determine the cause of neck or back pain. Medial branch blocks are performed when a pain provider feels the source of a patient’s back pain may be arising from the facet joints in the spine. Under fluoroscopy (x-ray guidance), numbing medication is injected near the facet joint in order to numb the nerves that innervate that facet joint. If the patient’s pain is caused by problems in the facet joints, they will experience significant pain relief for 2-6 hours after this procedure, at which time the numbing medication wears off. This procedure is used for diagnostic purposes; it is not meant to provide long-lasting pain relief. This procedure may need to be done on two separate occasions in order to ensure that the appropriate nerves are being targeted by the physician. If a patient experiences significant pain relief immediately after this procedure, radiofrequency ablation can be done at a later date to provide more long-lasting relief (typically six months to two years).
What are the expected results?
This is a diagnostic procedure that helps the physician determine where your back pain is coming from. If your pain does arise from the facet joints, you will experience pain relief for 2-6 hours after the procedure. Radiofrequency ablation can then be performed at a later date to provide more prolonged relief (typically six months to two years).
How long will it take?
The procedure itself only takes 30-60 minutes to perform. You will be observed in the recovery room for 30-60 minutes after the procedure.
After the procedure
Most often you can go home in about 30-60 minutes. Written instructions will be sent home with you. You may be given a pain diary to record pain levels for the next several hours after the procedure so that accurate results can be reviewed by the physician. You will need someone to drive you home and care for you for the first few hours after the procedure.
What to expect the day of your procedure?
You are expected to arrive at the surgery center at least one hour before your procedure is scheduled. Bring a responsible adult driver with you to take you home after the procedure. Unless you are certain you will not be receiving sedation, do not eat anything for 6 hours prior to your procedure; you may have modest amounts of clear liquids (liquids you can see through) up to 4 hours beforehand. Please take your regularly scheduled blood pressure, heart, and asthma with sips of water as you normally would. If you have diabetes, take half of your normal dosage and bring your insulin with you. Be sure to discontinue aspirin products and any other blood thinners as instructed.
After you arrive, you will be asked to sign-in and complete any paperwork as needed. You will then be taken to the preoperative area. At this time, a nurse will ask you some medical questions and have you sign your consent forms. It is imperative that you, the patient, inform the assistant of any changes in your history and/or physical, such as recent flu or any health problems that might affect your procedure. Inform the staff of any allergies, especially to Betadine or Iodine.
You may be asked to change into a gown. An assistant will take your vital signs. An IV may be started.
The physician and nurse will talk to you before your procedure. You will then be positioned and the injection sites will be prepped. Your pain management physician will perform the procedure. Afterward, bandages will be applied as needed.
You will be transported to the recovery room area where you will be monitored anywhere from 30 minutes to an hour. You will be offered beverages and some crackers. After this, someone will take out your IV and help you get dressed if needed. Lastly, your caregiver will be given discharge instructions for your care at home. You may be given a pain diary to record pain levels for the next several hours after the procedure so that accurate results can be reviewed by the physician.