Overview & Procedure
A medial branch block is a minimally invasive procedure that provides temporary relief to patients suffering from facet joint pain. Medial branch nerves transmit pain signals from damaged facet joints. It is important to note that medial branch blocks are used primarily for diagnostic reasons.
Insurance requires two separate Medial Branch Blocks with two different local anesthetics. These test injections are separated by 2 weeks. If a patient receives 80% relief of their pain for the duration of both local anesthetics, they are a candidate for radiofrequency ablation.
Step One: Medial Branch Block #1
During the procedure, the physician will clean and numb the injection site before using fluoroscopy (x ray imaging) to guide a thin needle to the medial branch nerve and inject the medication. If the patient experiences adequate pain relief from the procedure, a physician at Southwest Spine and Pain may suggest moving forward with Medial Branch Block #2
After Care
Immediately after the procedure, patients are sent to a separate room to recover. During this time, the patient’s vitals are monitored for any signs of an adverse reaction. As a diagnostic tool, the medial branch nerve block typically only provides temporary pain relief for 3-12 hours. During that time, the patient will be asked to track the amount of pain relief they receive. This will be evaluated at a follow-up appointment and will aid the physician in deciding the next treatment step. Patients should report any signs of a fever, infection, redness, swelling, and increased pain to their Southwest Spine and Pain Center physician immediately.
Step Two: Medial Branch Block #2
Scheduled two weeks after Medical Branch Block #1
During the procedure, the physician will clean and numb the injection site before using fluoroscopy (x ray imaging) to guide a thin needle to the medial branch nerve and inject the medication. If the patient experiences adequate pain relief from the procedure, a physician at Southwest Spine and Pain may suggest a subsequent therapy called radiofrequency ablation (RFA) for longer-lasting pain relief.
After Care
Immediately after the procedure, patients are sent to a separate room to recover. During this time, the patient’s vitals are monitored for any signs of an adverse reaction. As a diagnostic tool, the medial branch nerve block typically only provides temporary pain relief for 3-12 hours. During that time, the patient will be asked to track the amount of pain relief they receive. This will be evaluated at a follow-up appointment and will aid the physician in deciding the next treatment step. Patients should report any signs of a fever, infection, redness, swelling, and increased pain to their Southwest Spine and Pain Center physician immediately.
Step Three: Radiofrequency Neurotomy
Radiofrequency ablation (RFA) uses an electrical current to heat nerve tissue and reduce pain signals. RFA is a common procedure used to treat pain from arthritic joints in the cervical and lumbar spine. RFA is an outpatient procedure that takes 15 to 20 minutes and is typically performed with sedation.
After IV sedation has been given, the doctor will inject a local anesthetic to reduce pain. Using fluoroscopic guidance (X-ray imaging), a thin probe is guided to a target area. During the procedure, the doctor will ask the patient questions about their sensations to determine if the probe is in the correct area. Once the placement is verified, the radiofrequency process begins. The probe is heated, which cauterizes the small nerve tissue, transmitting chronic pain signals.
After Care
Immediately after the procedure, patients are sent to a separate room to recover. During this time, the patient’s vitals are monitored for any signs of an adverse reaction. Due to the nature of the procedure, a family member will need to drive the patient home at the time of release. It is recommended that the family member continue monitoring the patient for 24 hours after receiving IV sedation. Typically, patients resume full activity the next day. Soreness around the injection site may be relieved by using ice and taking a mild analgesic. Complications are rare, but if patients notice any signs of an infection, rash, or fever, we strongly encourage them to come into Southwest Spine and Pain Center.