Medial Branch Block

If you’ve experienced or are experiencing back and neck pain, you might assume that the pain is caused by a sore muscle, or possibly an issue with the spine. But, what you might not consider are the tiny nerves in the joints of the spine. After all, how can small nerves lead to such excruciating and chronic pain? For patients who haven’t found relief with at-home methods and who are still dealing with neck and back pain, medial branch blocks might be the solution. The Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas are experts in this minimally invasive treatment and diagnostic tool, and have helped their family of patients finally and comfortably experience pain relief. 

What is a Medial Branch Block?

A medial branch block (MBB) is a non-surgical injection that temporarily blocks the pain signals being sent by the medial branch nerves. The injection is an anesthetic and possibly a corticosteroid that works to reduce pain and inflammation, which keeps the brain from receiving the pain signals. 

To understand why the medial branch is targeted takes an understanding of the spine. As we know, the spine is made up of vertebrae, which help to support the body and protect the spinal column. In between each vertebrae are discs that help to cushion the vertebrae. These discs are further supported by facet joints, which allow a person to safely twist, reach, flex, etc. The medial branch nerves run through the facet joints in the neck, mid-back and low back, and send signals from the spine to the brain. 

Over time, arthritic changes in the facet joints or mechanical stress to the back (possibly due to an injury or an underlying health condition), can cause the facet joints to become irritated or inflamed. When this happens, the medial branch nerves send pain signals to the brain.  

What makes the medial branch block so effective is that the medication is placed directly next to the medial branch nerve, which helps to reduce inflammation and irritation in the facet joints. A pain management specialist might have previously tried a facet joint injection, which is where the medication is placed directly into the facet joint, but if that proved futile, then a medial branch block is a great option. 

Another reason why a medial branch block is a great option for patients who are suffering from neck and back pain is that in addition to providing pain relief, it also can be used as a diagnostic tool. Once pain relief is felt, the pain management specialist can confirm that the pain is in fact coming from the medial branch nerves and can recommend radiofrequency ablation, which is a more long-lasting and minimally-invasive treatment method. 

What Conditions Does a Medial Branch Block Treat?

A medial branch block is helpful in treating neck and back pain that is caused from the medial branch nerve. In addition to providing immediate pain relief that allows patients to enjoy their normal active lifestyle, the block can also be used as a diagnostic tool. This allows providers to treat a range of conditions, both health related and trauma related, that have caused a person to experience pain. The most common conditions that can be treated with a medial branch block include: 

• Osteoarthritis
• Facet joint pain
• Sacroiliac joint pain

Although not considered a medical condition, a medial branch block can also help to relieve sciatic pain, also known as sciatica. This pain is felt across the buttocks and down the hip and leg. Utilizing a medial branch block allows the patient to more comfortably take advantage of additional therapy options, such as physical therapy, while other treatment methods are used to address the underlying reason for the sciatic pain. 

What Does a Medial Branch Block Procedure Involve?

A medial branch block is an out-patient procedure, meaning that the patient will return home the same day. The patient will lie face down or on their side before the healthcare provider sterilizes the injection area and uses a local anesthetic to numb the injection site. Using fluoroscopy guidance, the provider will insert a needle into the area directly next to the medial branch nerve and will inject an anesthetic and a steroid, which works to relieve pain and reduce inflammation. 

The entire procedure should take around 15 minutes, depending on how many injections are administered. If immediate pain relief is felt, this means that the medial branch nerve is the source of pain. Patients can expect to feel pain relief for weeks to months. Your pain management specialist will then more than likely recommend radiofrequency ablation so that your pain relief is more long term. 

What are the Benefits and Risks of Medial Branch Blocks?

The main benefit of a medial branch block is that it offers patients a great tool to both experience pain relief and diagnose their cause of pain, all with few risks. Most patients experience very few side effects, with the most common being soreness at the injection site. However, that resolves quickly and the patient is able to resume normal lifestyle activities within a day or two after the injection. 

As with any medical procedure, there are risks. The risks with a medial branch block are low and include bleeding and infection at the injection site, as well as possible nerve damage (which is rare). Additional complications are directly related to the corticosteroid medication and can include elevated blood sugar, weight gain, arthritis, temporarily depressed immune system and stomach ulcers. It’s important to share all medical and health history with your provider prior to any treatment being rendered to avoid any complications. 

If you are suffering with neck and back pain and haven’t been able to find both pain relief or answers as to why you’re experiencing the pain in the first place, a medial branch block could be of tremendous help to you. This minimally-invasive and low risk injection treatment has helped patients enjoy a pain-free life in both the short and long term. If you have questions about medial branch blocks or would like to know if you’re an ideal candidate, please schedule an appointment today with the Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas. We look forward to hearing from you! 

A medial branch block interrupts the sensory nerve supply to the involved facet joint through the use of a precise administration of an anesthetic agent and steroid. After a local skin anesthetic is applied, the physician uses fluoroscopy (x-ray) guidance to place a needle along the nerves that supply the inflamed joint.

How long does it take?

Medial branch blocks are performed on an outpatient basis. The procedure typically requires 30 minutes, including preparation time. It is followed by 30 minutes of observed recovery time.

What are the expected results?

Medial branch blocks have been performed safely for many years with excellent outcomes. The benefit from this procedure will typically occur several minutes following the procedure. The patient is asked to record pain levels during the first days of the procedure to ensure accurate diagnosis of the facet joints as the pain source.

Nevada Advanced Pain Specialists is recognized as an industry leader in pain management. We have a state-of-the-art facility in Reno, Nevada, that allows for us to offer the highest possible level of quality care of our patients.

We are committed to providing a comprehensive and multi-disciplinary approach for each individual’s pain complaints to provide the most appropriate care. Our approach includes analysis of biomechanics, joint motion, as well as skeletal, nerve and muscle tissues. Every individual is evaluated for the root cause of their pain – not just a “quick fix” approach to only provide symptomatic relief.

Your pain will be evaluated with latest diagnostic tools and technologies used by the professionals at Nevada Advanced Pain Specialists to make accurate assessments including: EMG/Nerve testing, MRIs, x-rays, bone scans, and diagnostic pain injections.