The Purpose of Medial Branch Blocks

A local anesthetic is used to temporarily try to block these nerves from sending the pain signals on to the brain. If you have pain due to facet joint arthritis, you may feel relief of that pain for a few hours.

If significant pain relief is obtained through this temporary block, then you may be a candidate for a more long-lasting block of the nerves called medial branch radiofrequency neurotomy. Medial branch blocks are often used as a test to determine if radiofrequency neurotomy may help reduce your pain.

The Procedure

The patient is placed in the prone (lying face down) position with a pillow underneath the abdomen. The skin of the low back is sterilely prepared. Using fluoroscopic (X-ray) guidance, the bony landmarks are viewed. The skin is anesthetized. Under fluoroscopic guidance, thin needles are advanced to the appropriate area for medial branch blockade. A small volume of contrast solution is injected to prove that the medication will stay in the appropriate area. Then, a small volume of long-acting anesthetic is injected. The patient is cared for in the recovery area for 20 minutes.

Preparing for Medial Branch Blocks

  • For a diagnostic injection, you should have some pain at the time of your procedure or be able to consistently reproduce it with certain activities. If you are typically pain-free after taking pain medication, please do not take these medications for 4 to 6 hours before the injection.
  • There are no special dietary instructions for this procedure unless it includes sedation.
  • While the procedure may take less than 15 minutes, you should allow for at least 1 hour at the procedure center.
  • You need to arrange for a driver to be present and take you to and from the medical facility. If you do not have a driver with you, your procedure may have to be rescheduled.
  • Inform your doctor’s secretary if you have a pacemaker.
  • If you develop a fever, night sweats, or an active infection, your procedure will need to be rescheduled. Please contact our office at (651) 968–5201 immediately to inform us of your change in condition.

After the Injection

After the procedure, you should try to gently reproduce your pain and inform your care team of the percentage of relief you obtained from the injection.