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INJECTIONS FOR BACK PAIN

	Atlanto-Occipital Joint Injections Cervical Steroid Injections Discogram/Discography Epidural Steroid Injections Facet Joint Injections Facet Joint Injection FAQ Hip Joint Injections Lumbar Steroid Injections Medial Branch Block Medial Branch Block FAQ Radiofrequency Neurotomy Sacroiliac Joint Injections Selective Nerve Root Block (SNRB) Steroid Injection FAQ
SURGICAL PROCEDURES

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ANATOMY OF THE BACK

	Cervical Anatomy (Neck) Thoracic Anatomy (Mid Back) Lumbar Anatomy (Low Back) Sacrum Anatomy (Tailbone)
PATIENT RESOURCES

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Medial Branch Block FAQs

What is a Medial Branch?

Facet Joints are innervated or “supplied” by nerves called “medial branches”. These nerves carry the pain signals to the spinal cord and the signals eventually reach the brain, where the pain is noticed.

What is the purpose of it?

If the nerves are “blocked” or “numbed”, they will not be able to carry pain sensation to the spinal cord. It is like temporarily cutting off “wires”. Therefore, if the pain is due to facet joint arthritis, you should have relief from pain and stiffness. Once it is determined that the pain is indeed due to facet joint disease, we can use a procedure called “Radiofrequency Lesioning” to burn off these nerves for a longer duration pain relief. So, in a way, medial branch block is a temporary and diagnostic procedure.

How long does the injection take?

The actual injection takes only a few minutes. The more nerves that need to be blocked, the more time it takes.

What is actually injected?

The injection consists of a local anesthetic.

Will the injection hurt?

The procedure involves inserting a needle through skin and deeper tissues. Therefore, there is some discomfort involved. However, we numb the skin and deeper tissues with a local anesthetic using a very thin needle before inserting the needle. Most patients also receive intravenous sedation and is asleep during the procedure.

How is the injection performed?

It is done with the patient lying on the stomach and under x-ray control. The patients are monitored with EKG, blood pressure cuff and blood oxygen-monitoring device. The skin in the back is cleaned with antiseptic solution and then the injection is carried out.

What should I expect after the injection?

Immediately after the injection, you may feel that your pain may be gone or quite less. This is due to the local anesthetic injected. This may last only for a few hours. Your pain will return and you may have a “sore back or neck” for a day or two. This is due to the mechanical process of needle insertion. It is very important for you to keep a track of your pain and stiffness for the next 2 to 12 hours following injections. Your response to the injections will determine if the facets are the cause of your pain.

What should I do after the procedure?

You should have a ride home. We advise the patients to take it easy for a day or so after the procedure. You may want to apply ice to the affected area. Perform your usual activities as tolerated.

Can I go to work to work the next day?

Unless there are complications, you should be able to return to your work the next day. The most common thing you may feel is a sore neck or back.

How long does the effect of the medication last?

The immediate effect is from the local anesthetic injected. Depending upon the medication injected, it can last from 2 hours to 8 hours. Of course, if the facet joints are not the source of your pain, you may not have much relief later.

How many injections do I need to have?

Usually one session is enough to determine if the facet joints are the most likely source of your pain. However, the “placebo response” can be as high as 30 to 40 % and some patients may be recommended to have repeat diagnostic injections. In addition, “False Positive” responses can occur.

Will the procedure help me?

If the pain is originating mostly from the facet joints, you should benefit from this procedure on a temporary basis. Please remember that these are diagnostic injections only and last only for a few days. These are done to determine if the pain is coming from the facet joints or not, and if the pain is coming from the facet joints, we will recommend “Radiofrequency Lesioning” – which will “numb” the same nerves for many weeks to months.

What are the risks and side effects?

Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. It is rare to have any complications after these procedures.

Who should not have this injection?

If you are allergic to any of the medications to be injected or you have an active infection, then you cannot have the procedure. If you are on a blood thinner, these medications should be stopped for a time period prior to the procedure.