Medial Branch Blocks


What is a medial branch block?

Medial branch nerves are very small nerve branches that carry the pain message from the facet joints and the muscles around the joints. If the nerves are blocked or numbed, they will not be able to transfer the pain sensation from the joints to the brain.



Where are facet joints?

The facet joints are small joints in the back of the spine that form connections between each vertebra. Each vertebra has a surface on four facet joints, two on the upper or superior surface and two on the lower or inferior surface of the vertebrae. The facet joints limit how far you can twist or bend your back and neck.


What is the purpose of this procedure?

This is a diagnostic procedure. This injection is done to confirm the diagnosis of facet joint disease and to find out if the facet joints are contributing to your pain.


How much time does the injection take?

The procedure can take from 15 to 45 minutes depending on the number of levels.


What medicine is injected?

We inject a local anesthetic.


How is the procedure performed?

The patient lies on his/her stomach. The skin of the back is cleaned with antiseptic solution and is injected with local anesthetic, after which the nerve block is performed under X-ray guidance.


How long does the effect of the medication last?

If the facet joints are the source of pain, you should benefit from the injection immediately. Depending upon the medication injected, the effect can last from 1 hour to 6 hours or more.


What is the next step after having good relief?

If you benefit from the procedure, the next step would be consideration of radiofrequency treatment of the medial branch nerves.


What are the risks and side effects?

Serious side effects and complications are uncommon. The most common problem after the injection is having pain in the area of injection for a few days. The other complications are infection, bleeding and nerve injury.


Who should not have this injection?

If you are taking blood thinners (Coumadin, Plavix, Ticlid or others) or antibiotics, have an active infection, or have a bleeding disorder you should not have the procedure without further discussion. Please warn us of any allergies you have, especially to local anesthetics, X-ray dye and latex.

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