Medial Branch Block Injections

Medial Branch Anatomy

Facet joints are the joints connecting the different vertebrae of the spine to each other. Medial branch nerves are small nerves that supply the facet joints of the spine.

What is a Medial Branch Block?

A medial branch block is an injection of a local anesthetic administered near the medial branch nerves to temporarily block the pain signal carried from the facet joints of the spine to the brain. It assists your doctor in diagnosing the cause of your back pain.

If a medial branch block is successful in confirming that the pain is originating from the facet joints, radiofrequency rhizotomy is suggested to provide longer pain relief.

Indications and Contraindications of Medial Branch Block

Medial branch block injections are usually indicated for back pain that originates from arthritic changes in the facet joints or mechanical stress to the back. A medial branch block can be performed to diagnose or treat pain arising from the facet joints.

The procedure cannot be performed if you are taking blood-thinning medications or have an active infection. Also, inform your doctor if you are allergic to medications used in the procedure. Be sure to discuss these situations with your doctor before the procedure.

Preparing for a Medial Branch Block

You are advised to avoid driving and engaging in any vigorous activities on the day of the injection.

Medial Branch Block Procedure

  • A medial branch block procedure is performed under fluoroscopy (X-ray) guidance to ensure the accurate placement of the needle and to avoid nerve injuries.
  • You will be made to lie on your stomach on an X-ray table. The area of the skin to be injected is cleaned properly and a local anesthetic administered to numb the skin. A stinging or burning sensation may be felt for a few seconds. A small needle is then directed into the medial branch nerve area, under X-ray (fluoroscopy) guidance. Contrast dye is used to confirm the location of the needle over the medial branch nerves. A small mixture of the numbing agent and medication is then slowly injected over the targeted nerves.
  • The whole procedure takes about 10-15 minutes and you can go home on the same day.

What to Expect after a Medial Branch Block

After the medial branch block, your pain may

  • Be relieved for a few hours
  • Be relieved for a few days
  • Not reduce at all

If the pain is relieved after the medial branch block, it indicates that the origin of the pain is the medial branch nerve supplying the facet joint.

Based on the amount of pain relief observed during the first 4-6 hours after the injection, you may be considered suitable for a radiofrequency neurotomy procedure to relieve the pain for a longer period.

In radiofrequency neurotomy, an electrical current is passed through a needle at the selected medial branch nerve causing pain to interrupt the pain signals.

Post-procedural Care following a Medial Branch Block

  • You should arrange for someone to drive you home after the procedure.
  • You may continue your routine prescribed medications after a gap of 4-6 hours following the procedure to avoid incorrect assessment of diagnostic results related to pain relief.
  • You may experience localized pain at the injection site in the first 2-3 days, for which ice packs can be applied to ease the discomfort.
  • You can return to your regular activities, a day after the procedure.
  • In cases where improvement in the pain is seen, you are advised to perform moderate activities, with regular exercises.

Risks and Complications a Medial Branch Block

Although a medial branch block injection is a safe procedure, the possible risks and complications associated with the procedure may include:

  • Allergic reaction, usually with X-ray contrast dye
  • Bleeding from the site of injection
  • Infection at the site of injection
  • Discomfort at the site of injection
  • Increased pain
  • Nerve or spinal cord damage and rarely, paralysis
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Rating & Review

Melinda Bess
Melinda Bess
2024-02-14
Dr. Iqbal is the best pain management doctor I have ever had and will have. She does her homework first which I think makes the difference in diagnosis. She is the total package, a very smart and beautiful doctor, wife, and mother. Hand on Bible she changed my life, and I will forever be in debt to her. I can't say thank you enough. I appreciate her staff; they are all awesome as well. I laughed and cried in her office, but her smile and staff always made me feel welcome like part of their family. I would and will drive across country to see her. The referral to a new knee surgeon to fix a bad knee replacement was the best. I got a new knee, and it has been a huge blessing as well. Thank you, Dr. Iqbal and staff you all are 5 stars, in my life.
Nikin Mehta
Nikin Mehta
2024-02-13
Brian Knopf
Brian Knopf
2024-02-13
Dr. Iqbal and her staff are fantastic! I couldn’t have asked for a better experience. I highly recommend her and her team
Brenda Jones
Brenda Jones
2024-02-02
I visited this facility in January for severe back pain I was experiencing. The whole ordeal from beginning to end was amazing. I wish I had known about this place years ago before suffering from so much pain. Dr. Mehreen Iqbal, her assistant Michealle Dooley and their staff is the best. I had a procedure done on 1/17/24 and I no longer suffer from back pain and I'm able to walk again. I highly recommend this facility, 10 Stars!!!
Ann Adkins
Ann Adkins
2024-02-01
Wonderful experience with Dr. Iqbal & her staff! She is amazing! She listens to her patients & immediately developed a plan to address my back & neck pain. I already feel SO much better and am confident that her plan for me will mean continued improvement. Her staff is wonderful too - friendly, helpful & responsive. I highly recommend Dr. Iqbal & her team!
Camille Adams
Camille Adams
2024-01-22
The staff are very kind and helpful, and Dr. Iqbal is very good at what she does. Would recommend to all my friends and family.
Noor Malik
Noor Malik
2024-01-02
My PCP recommended Dr. Mehreen and she was wonderful through out the entire injection process. She took her time explaining everything and was patient through out the process. In my opinion, she is the best pain management doc around.
Jessie Wilson
Jessie Wilson
2023-12-08
I love Dr. Iqbal and her staff, I couldn't be any luckier to have found her practice. Dr. Iqbal listens well and explains in detail any procedures. She is honest, caring, and down to earth. She and her staff are the greatest. I would recommend her to any of my friends or family.
Shimmerynight Skies
Shimmerynight Skies
2023-12-08
My mother is a patient here and the staff is super nice, fun, and sweet! I highly recommend coming here for friendly service
M
M
2023-12-04
Excellent doctor. Dr. Iqbal explained every thing in detail and laid out a very clear plant to treat the problem/pain.