Medial branch block
Medial branch block is a strong anaesthetic injection given to the small nerves that supply the facet joints in the spine and carry pain signals from the facet joints to the brain. The injection disrupts pain signals sent from the medial branch nerves and hence gives relief to the patient.
It is indicated for a variety of acute and chronic conditions that causes inflammation and pain of the facet joints. Cervical, thoracic or lumbar facet joints are small joints at specific segment of the spine that provide stability and help guide motion.
Purpose of the procedure
Medial branch block is mainly a diagnostic procedure performed to confirm the diagnosis of facet joint disease and to find out which facet joint is responsible for the pain.
Procedure of Medial Branch Block
The procedure to give injection is performed under fluoroscopy (live X-ray) guidance to properly target nerve, place the needle and avoid any injury. It can be done with or without sedation depending upon the anxiousness and comfort level of the patient.
A very small needle is directed over the medial branch nerves under fluoroscopy. After confirmation, a small amount of numbing medicine (anaesthetic) is slowly injected onto each targeted nerve. Patient will feel relief from pain within first few hours or early after the injection.
How many injections are required to get relief?
In almost all the cases, just one injection in the region of facet joint (lumbar, cervical, thoracic, etc.) relieves the patient from pain and inflammation as multiple levels are blocked simultaneously. It is generally followed by radiofrequency lesioning of the medial branch nerve for prolonged pain relief.