Frequently Asked Questions on Medial Branch Blocks
What is a medial branch block?
Medial branch injections are performed by pain management doctors around the facet joints of the spinal column. There are two facets joints at every level of the spine (right and left), and they are thumbnail sized joints that are prone to arthritis just like any other weight-bearing joint with cartilage.
The word “block” is the same as an injection, and the medial branch block involves injection of numbing medicine and maybe steroid around painful facet joints.
This may be in the cervical, thoracic or lumbar spine. Each joint receives sensation from nerves known as the medial branches. These are not large nerve roots, rather, they are small nerve endings that supply the joints with sensation, and hence the ability to feel pain.
For what conditions are medial branch blocks helpful?
These injections serve two purposes in Las Vegas pain management. The first purpose is to figure out if the facet joint is the source of an individual’s pain. The typical problem is facet joint arthritis, which is also known as facet syndrome.
For such a small joint, a facet joint can lead to a tremendous amount of pain and an individual. When medial branch blocks are performed, they are often performed at multiple levels because it is often more than one facet joint that is arthritic and causing a person’s pain.
The second reason that a medial branch block injection is performed is for therapeutic reasons. Not only can the numbing medicine injected help with pain relief in the short run, but may be able to provide weeks to months of significant pain relief as well. For this reason, the medial branch block serves both a diagnostic purpose along with a therapeutic one.
How is a medial branch block injection performed?
These spinal injections are performed as an outpatient and may be done either in a Las Vegas pain clinic procedure room or a surgery center. Pain doctors in Las Vegas will use either fluoroscopy or ultrasound as image guidance. These methods will increase the accuracy of the injections.
Numbing medicine underneath the skin will be placed through the soft tissues down to the area overlying the facet joint. Then once the physician is sure about needle placement, numbing medicine is placed into the area of the medial branches.
For 30 to 60 minutes after the procedure, patients will be monitored to ensure stable vital signs and no allergic reaction ensues.
How effective are medial branch injections?
Research has shown that medial branch block injections may be very effective for pain relief in both the cervical and lumbar spine. One study has shown an average pain relief of three to five months, and they may simply be repeated with the expectation of another excellent result.
The injection may only produce partial pain relief, and if multiple arthritic facet joints are contributing to the patient’s pain then this is understandable.
If the medial branch block helps with over 50% pain relief, and then wears off, the Las Vegas pain management doctor can either repeat the procedure or go on to what is known as a radiofrequency ablation. Most insurance companies will approve the RFA procedure at a pain relief percentage of either 50 or 80%.
A radiofrequency ablation procedure, also known as a radiofrequency neurotomy, involves heating up the area where the medial branches are and deadening those nerve endings. This may provide pain relief for well over a year at a time.
What are the risks of a medial branch block?
These procedures are extremely low risk. The needle is not intended to go into the spinal canal, which makes the risk profile even lower than an epidural steroid injection. With the medial branch block, there is a small risk of infection, bleeding and the biggest risk is that it will not provide pain relief.
If you are on blood thinning medications, they should be stopped 5 to 7 days prior to the injection. Your pain management Las Vegas doctor will specify the exact timeframe.
If you or a loved one is suffering from chronic neck or back pain, a medial branch block may help considerably. Call a Las Vegas pain management clinic today for an evaluation and successful treatment.