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Medial Branch Block

A medial branch block is an injection of a strong local anesthetic (numbing agent) on the medial branch nerves that supply the facet joints. This procedure is a diagnostic test, meaning any pain relief is expected to be temporary. With the appropriate short-term response, this helps your provider decide if you are a candidate for another procedure called a medial branch radiofrequency neurotomy (ablation), which provides longer term pain relief.

Before the procedure
  • You will be asked to hold aspirin and other blood thinning medications. Clearance may be required from your physician.
  • Food and drink restrictions will be implemented.
  • Anxiety reducing medication may be prescribed and sent to your preferred pharmacy with instructions given for taking the day of the procedure.
  • You will be asked to have a driver available to get you home safely post procedure.
What to expect
  • You must have a measurable amount of pain on the day of your procedure. Otherwise there is no way to determine if the injection was done in the area of your normal pain.
  • You will first be taken to the pre-procedure area where we will take your vital signs, have you sign the consent form, and answer questions about the procedure.
  • Once in the procedure area, your skin will be cleaned with antibacterial soap and medications will be prepared.
  • The procedure typically takes about 15 minutes
  • It will be carried out using x-ray guidance.
  • Your vital signs will be monitored and staff will walk you through all aspects of the procedure as they are happening.
  • You will be allowed to leave 10-30 minutes post procedure or as determined safe by staff.
After the procedure
  • You will be given written discharge instructions to refer to post procedure
  • Unlike other injections, you will be instructed to perform the activities that normally cause or increase your pain immediately after the procedure. DO NOT GO HOME AND REST.
  • You will be given a pain diary to journal your pain rating every 30 minutes to an hour. Your response will determine if your pain would likely improve if the small nerves at the area injected were ablated.
  • Your pain relief is expected to be TEMPORARY. This is a diagnostic test only. It is imperative you provide quality, measurable feedback post procedure using the pain diary.
  • You will be instructed how to return the pain diary to your provider to determine the next step in treatment.
  • Ice and medications previously used for pain may be used immediately and for the next few days as needed.