Medial Branch Block
What is a Medial Branch Block?
A medial branch block involves injecting medication near the small nerves in the spine that send signals from the facet joints. Rather than being injected directly into the joint, the medication is administered near these nerves along their course.
The injection typically contains a local anesthetic that temporarily numbs the nerve pathway. Medial branch block injections are most commonly used to determine whether pain originates from the facet joints in the neck or back. The aim is to pinpoint the exact source of the pain.
Types of Medial Branch Blocks
A lumbar medial branch block involves injecting medication near the medial branches of the lower back (lumbar spine), which transmit pain signals from the facet joints in that region.
A cervical medial branch block involves injecting near the medial branch nerves in the neck (cervical spine), close to the nerves that supply the facet joints.
A thoracic medial branch block involves injecting medication near the medial branches of the upper or middle back (thoracic spine), targeting the nerves associated with the facet joints in that area.
When Medial Branch Blocks Are Recommended
- Possible facet joint pain. When your neck or back pain seems to be coming from the small facet joints in the spine (like from arthritis or age-related changes).
- Chronic neck or back pain that hasn’t improved enough with basic care. When things like activity changes, meds, or physical therapy haven’t gotten you where you need to be.
- Pain that occurs when the spine moves, especially during bending, twisting, extending, or in specific positions.
- Facet joint osteoarthritis. When arthritic changes in facet joints are a likely pain source.
- Spinal osteoarthritis. When arthritis in the spine is suspected to be causing pain.
- Degenerative spondylolisthesis. When a slip in the spine may irritate facet joints and cause pain.
- Inflammatory arthritis affecting the spine. In cases where conditions like rheumatoid arthritis or ankylosing spondylitis may involve the spinal joints.
- Spinal alignment issues. When scoliosis or other alignment problems may be stressing facet joints and causing pain.
How Are Medial Branch Blocks Performed
Medial branch block injection is typically done as an outpatient procedure with image guidance. Patients usually lie face down on a procedure table. The treatment area is disinfected, and a local anesthetic is used to numb the skin, improving comfort.
After that, a fine needle is carefully inserted toward the medial branch nerves, most often with X-ray (fluoroscopy) imaging to guide placement. A small dose of contrast dye may be used to confirm the needle’s correct position. Once confirmed, medication is delivered near the intended nerves. The procedure generally lasts around 20–30 minutes, and most patients can return home the same day.
Benefits of Medial Branch Blocks
The medial branch nerve block offers two primary benefits. First, it helps verify whether your pain stems from the facet joints in your spine by temporarily blocking the small medial branch nerves that transmit pain signals.
Second, they can help predict subsequent outcomes. If you find significant relief after the block, it often suggests you may be a good candidate for longer-lasting treatments like radiofrequency ablation.
Many patients experience immediate temporary pain relief after the injection, though the duration varies.
What is the Next Step After a Medial Branch Block?
Most patients go home the same day after a medial branch block. You may feel soreness at the injection site, but it usually goes away quickly. It’s important to watch how your pain changes over the next few hours. Because the injection often contains a local anesthetic, you might notice significant pain relief for several hours. Some may experience relief for one or two days, while others may see little change. Overall, recovery time from a medial branch block is very brief.
We also ask that you track your pain levels and note which movements feel easier or remain difficult. This feedback helps determine if your facet joints are contributing to your pain. If you get significant relief after the injection, you could be a good candidate for radiofrequency ablation, a procedure designed to offer longer-lasting relief by blocking pain signals from the affected nerves.
Risks and Considerations of Medial Branch Blocks
- Risks: The medial branch nerve block is usually safe, but it may cause temporary soreness or bruising. There's a small chance of bleeding or infection. Some people might experience a short-lived pain flare from the medication or contrast dye. Rarely, the anesthetic can cause temporary numbness or weakness in the surrounding area.
- Considerations: Relaxing and taking it easy for the rest of the day. Please let us know in advance if you are on blood thinners, have an active infection, or have drug allergies. If you have diabetes, your blood sugar may be temporarily elevated after the injection.
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Choose Painless Medical Practice for a Medial Branch Block in Chicago, IL
At Painless Medical Practice, we take a medically driven approach to medial branch blocks. Your care is led by Jaroslav Tymouch, MD, the Founder of our clinic, and we ensure this procedure is appropriate for your case before proceeding. We create a deeply personalized treatment plan based on how you respond, not endless visits for quick relief.
If you’re looking for trusted pain management in Chicago, IL, we’ll explain the process in plain language and keep things efficient. Book an appointment to see if a medial branch block or facet injections make sense for your health.
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FAQs About Medial Branch Block in Chicago
What Is a Medial Branch Block?
A medial branch block is a minimally invasive diagnostic injection used to determine whether neck or back pain originates from the facet joints of the spine. Instead of injecting medication directly into the joint, a local anesthetic is placed near the medial branch nerves that transmit pain signals from the facet joints.
If the pain significantly decreases after the injection, it confirms that the facet joints are likely the source of discomfort. This information helps guide further treatment decisions.
How Long Does a Medial Branch Block Last?
The pain relief from a medial branch block is typically temporary. Because the injection usually contains a local anesthetic, relief may last several hours. In some cases, patients may experience improvement for a day or two.
The primary purpose of the procedure is diagnostic rather than long-term treatment. The duration of relief helps your provider determine whether you may benefit from longer-lasting procedures, such as radiofrequency ablation.
What Is The Next Step After a Medial Branch Block?
The next step after a medial branch block depends on how much pain relief you experience. Patients are usually asked to monitor their pain levels and note any improvement in movement or daily activities during the first several hours after the procedure.
If you experience significant temporary relief, you may be a strong candidate for radiofrequency ablation, a treatment that provides longer-lasting pain relief by disrupting the medial branch nerves. If relief is minimal, your provider may recommend additional diagnostic testing or alternative treatment options.
Is a Medial Branch Block Injection Painful?
Most patients tolerate the procedure well. A local anesthetic is used to numb the skin before the injection, and the procedure is performed under imaging guidance for precision. Some mild pressure or temporary soreness at the injection site is possible, but serious discomfort is uncommon.
Who Is a Good Candidate For a Medial Branch Block?
You may be a candidate if you have chronic back or neck pain that worsens with bending, twisting, or extension, especially when conservative treatments like physical therapy or medications have not provided sufficient relief. It is often recommended when facet joint arthritis or spinal degeneration is suspected.
What People Say About Medial Branch Block
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If you are looking for a knowledgeable, compassionate and highly skilled professional, I highly recommend Dr Tymouch. His expertise truly stand out!
Dr. Tymouch took the time to carefully explain everything, answer my questions, and made me feel completely at ease throughout the entire visit. He treated my knee pain with injections, and the results were truly amazing and fast. I happy that I will be able to enjoy my vacation without discomfort. I’m so grateful for his care and highly recommend Dr. Tymouch to anyone in need of expert, compassionate treatment.
The team is professional, compassionate, and highly skilled at managing different types of pain.
