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A medial branch block is an injection that helps pinpoint the cause of chronic spine pain, so you can pursue the most effective treatment options. It temporarily interrupts pain signals from specific nerves in your spine, and here’s how it works.
Chronic neck and back pain can make every aspect of life more difficult, from performing at your job to getting a good night’s sleep. And unfortunately, it can be hard to know exactly what’s causing the discomfort. That’s where a medial branch block comes in.
Medial branch blocks are a diagnostic, minimally invasive injection that helps identify the source of your chronic back or neck pain. These injections are especially useful when pain comes from the small joints in your spine (called facet joints), because they temporarily block pain signals that travel from the facet joints to your brain.
Ready to learn more? At Centers for Pain Control and Vein Care, our team takes a comprehensive approach to pain management, and that includes medial branch blocks to get to the bottom of chronic spinal discomfort. Here’s a simple explanation of this pain injection, as well as how to decide if it might be right for you.
The connection between medial branch nerves and chronic pain
Facet joints are the tiny joints between each vertebra in your spine. These joints help your spine bend, twist, and absorb movement, and each one contains small nerves called medial branch nerves.
Medial branch nerves transmit sensation from the facet joints in your spine to your brain, and those sensations include pain signals. When a facet joint gets irritated from a condition like arthritis or even previous injury, the nerves transmit pain signals. When the inflammation is chronic, the pain often becomes chronic, too.
How medial branch blocks work
A medial branch block is a targeted injection that contains an anesthetic (and sometimes anti-inflammatory medication). We place it near the medial branch nerves that supply one or more facet joints in your spine, with the goal of temporarily numbing the nerve and interrupting pain signals.
Medial branch blocks are a diagnostic tool that can help us determine whether those nerves (and the associated joints) are the source of your pain. It tests how your pain levels change when the nerve is blocked, and if your pain significantly improves after the block, it suggests that the specific facet joints and nerves targeted are major contributors to your symptoms.
Because medial branch blocks are primarily diagnostic, the pain relief they provide is usually temporary, often lasting only as long as the anesthetic’s effect. But this short-term response is valuable: if the medial nerve block was successful, you might be a good candidate for similar treatments aimed at longer-term relief, like radiofrequency ablation (RFA).
When you might need a medial branch block
We may recommend trying a medial branch block if you have chronic neck or back pain that hasn’t responded well enough to conservative treatments, and we suspect that the pain is coming from one or more facet joints (for example, pain that worsens with twisting, bending, or certain movements).
What happens when you get a medial branch block
We do medial branch blocks on an outpatient basis in our office. You’ll lie on your stomach on the exam table, and we cleanse and numb the skin over the treatment area. Next, we use fluoroscopy (real-time X-ray imaging) to guide the thin needle to the target nerves and inject a small amount of anesthetic near the medial branch nerves.
The entire procedure takes about 15-30 minutes, and you’re free to go home afterward. If those medial branch nerves are the source of your pain, you may feel noticeable pain relief shortly afterward, but it’s important to remember that it’s often temporary as the anesthetic wears off.
After you get a medial branch block, you have a follow-up appointment to discuss your results. If you notice less pain after the medial branch block, we can consider options like RFA, which uses heat to disrupt the same medial branch nerve and offers longer-lasting pain relief. If you didn’t notice any change, we can recommend other options to evaluate and address your pain.
Our team at Centers for Pain Control and Vein Care are ready to help you better understand your pain and find an appropriate, effective path forward. Contact us online or call our offices in Hobart, La Porte, Merrillville, Munster, or Valparaiso, Indiana, to learn more.