The medial branch block procedure: everything you need to know

Back pain is extremely common among the UK population and can make daily life debilitating for some people.One method of aiding such back pain is medial branch block. Here to explain more about the procedure is Dr Ralph Rogers, a highly regarded consultant in sports medicine and regenerative orthopaedics.

What is a medial branch block and what are facet joints?

Medial branch nerves are tiny nerve branches responsible for transmitting pain signals from facet joints to the brain, where the sensation of pain is perceived. The facet joints are small joints in the back of the spine that form connections between each vertebra. If they become blocked or numb, the nerves cannot transfer the painful sensation from the joints to the brain. The medical branch block procedure is therefore performed to determine if the patient’s back pain is being caused by the facet joints.

How is the medical branch block procedure performed?

In order to perform the procedure, the patient must lie on their stomach. The skin of the back is cleansed with antiseptic solution and a local anaesthetic is injected as a way of numbing the area. Following this, a small needle is guided using an X-ray to the targeted medial branch nerve which is then numbed with local anaesthetic such as lignocaine. The injection takes about 15 minutes to complete.

Does the injection hurt?

The patient will feel some slight discomfort with needle insertion. However, this will be minimised by numbing the skin over the nerves with a local anaesthetic.

How long does the effect last?

The effect of the injection will last several hours or more. This is strictly a diagnostic block to test if the facet joint is the real source of some of the patient’s pain. Due to this, it is essential that each patient fills out a pain log.

After the anaesthetic medical wears off, it is likely that the pain will return, meaning that patients will experience heightened soreness for one or two days.

What is the next step after the injection?

If the procedure proves beneficial to the patient, they may consider having radiofrequency (Cooled RF) treatment of the medial branch nerves. This procedure provides pain relief for a longer period of time (an average of one year).

What are the risks and side effects?

It is rare that a patient will suffer from severe side effects or complications from medical branch block. However, they may experience complications such as infection, bleeding or nerve therapy. Such complications can be minimised through the use of sterile techniques and fluoroscopy for X-ray needle guidance.

If you are experiencing back pain and would like to book a consultation with Dr Rogers, simply visit his Top Doctors profile today.