What are medial branch blocks?
Medial branches are the nerves that supply the facet joints. Since we cannot make the spine younger or less degenerative, what we aim to do is turn off the painful signal that comes from those joints. The medial branch nerves are the messengers of this painful signal, and by blocking them with numbing medicine we can oftentimes turn off the pain. These nerves do not provide any other significant function other than to tell you that you have arthritis in your joints. This is one instance where we want to ‘kill the messenger’, so to speak.
What should I expect during medial branch blocks?
During the procedure, the doctor will first clean off the skin and use X-ray guidance to identify the area where the medial branch nerves live. Then, the doctor will numb up the skin with a pinch and a burn at four sites. The doctor then places the needles down to the area where the nerves run and double-checks with more X-rays. Once in satisfactory position, the doctor injects a long-acting numbing medication onto the medial branch nerves.
What should I expect after medial branch blocks?
This is a diagnostic procedure, which means that we are testing to see if it takes away your pain. As such, you will be asked to fill out a pain diary documenting any relief you experience every hour for the first 12 hours after the injection, and also at several time points thereafter. We want you to be active during this time to really test whether or not the injections relieve your pain.
If the medial branch blocks relieve your pain while the numbing medicine is working, then you may be a candidate for a long-acting procedure called a radiofrequency ablation or rhizotomy.