Medial Branch Blocks

 

Description

 

Medial branch blocks is a procedure performed to determine whether a facet joint is a major source of pain for the patient.  Facet joints are located along the entire length of the spine from the neck to the lower back, where one vertebra slightly overlaps another. These joints guide the spine’s movement.  Each arthritic and painful facet joint sends the pain signal up to the brain via a very small nerve called the medial branch.  By numbing up these tiny nerves, we effectively numb the facet joints; therefore no pain would be felt from the joints for several hours.

 

How It’s Performed

 

After the patient is given a local anesthetic (numbing medicine for the skin/muscle/fat), a facet joint block is done by inserting a thin needle through the numbed skin/muscle and down to the area of the facet joint medial branch nerves.  Dr. Faubel watches on a live low-dose x-ray machine called a fluoroscope as he guides the needle to make sure it goes into the correct area.  The x-ray allows for precision and safety.  Once Dr. Faubel is sure the needle is in the correct area, he will inject a small amount of anesthetic (lidocaine) to numb the facet joints.

 

Candidates For This Procedure

 

If you have neck, low back, buttock, or sometimes upper back and upper leg pain stemming from inflammation, irritation or arthritis of your facet joints, you may benefit from a facet joint radiofrequency ablation.  A thorough history and examination by Dr. Faubel will help to determine this.

 

How Long Does The Procedure Take

 

The entire procedure usually lasts about 15 minutes.

 

Recovery

 

No recovery is needed.  

 

Instruction After The Procedure

 

Since this test is used to determine if the cervical or lumbar facet joints are the source of your pain, Dr. Faubel will want you to be physically active for a few hours afterward.  Think of some activity that normally worsens the pain, and do that.  Examples are shopping, cleaning the house, etc.  You'll be instructed to call my medical assistant 4-5 hours after the procedure to give us an update on how much pain was relieved (percentage of pain), and for how long.

 

Results

 

If the facet joints are the cause of the pain, the patient will experience immediate pain relief of 80-100% that will last for 3-5 hours (the duration of the lidocaine medicine).  If two successive facet joint blocks are successful, the next and final step is radiofrequency lesioning that will provide usually 12 months of great pain relief.