Medial branch blocks are extremely effective outpatient pain management procedures that are performed thousands of times a day across America.
What exactly is a medial branch block?
This procedure involves the injection of numbing medicine around the facet joint in either the neck or the back. Steroid medication may or may not be included with the procedure, and the injection serves two purposes. The first reason for receiving a medial branch block is for diagnostic purposes. It can tell the Florida pain management doctor whether or not that particular arthritic joint is causing some of the patients discomfort.
The second purpose of a medial branch block is for therapeutic reasons. Studies show that medial branch blocks provide on average, 2 to 3 months of exceptional pain relief for the affected joint.
What are the medial branches?
Each joint in the spine receives sensation from tiny nerve endings. In order for a joint to be painful, it needs a nerve supply. These nerve endings are known as medial branches and they come off of nerve roots as they exit the spinal cord.
The purpose of the block is to stop the nerve endings from signaling pain to a person’s brain.
There are two medial branches that supply each facet joint, one coming in from above and one from below. This is why the injections involved the needle going into two areas.
How are these injections performed?
This is an outpatient procedure performed in a procedure room or in an ambulatory surgery center. IV sedation is not necessary and typically the pain management doctor will numb up the skin and the soft tissues down to the affected joint.
Most modern pain doctors use fluoroscopy for the procedure, which is a real time form of x-ray. This helps ensure the highest accuracy for needle placement.
Once the accuracy is satisfactory, typically contrast is injected to ensure additional placement. At that point, the numbing medicine and possibly some steroid is injected into places around the facet joints.
For this procedure, the needle does not enter the joint itself, but stays around the joint to block the medial branches.
Once the procedure is completed, patients are monitored in the recovery room for 30 to 60 minutes to ensure stable vital signs and no allergic reaction occurs. The patients are then allowed to go home.
What are the results of the procedure?
As a diagnostic procedure, medial branch blocks have shown excellent accuracy for figuring out the source of an individual’s pain. This goes for both the neck and the back.
In addition, these injections have shown to have an 80% effectiveness for relieving facet related pain. Studies have shown that the pain relief with medial branch blocks averages 2 to 4 months. This has even been shown without the steroid medication.
If the medial branch block works well for pain relief and then wears off, a radiofrequency ablation may be performed which can provide an additional 6 to 18 months of pain relief.
Usually, this procedure is approved by insurance companies with a 50 to 80% pain relief from the medial branch block.
What are the risks of this procedure?
Risks with a medial branch injection are extremely low. There is a very small risk of infection, nerve injury, bleeding, or allergic reaction to the anesthesia. Because the injection does not go into the spinal canal, it would be exceptionally rare to have a neurologic injury result.
For patients who are on blood thinning medications., those medications should be stopped 5 to 7 days prior to the procedure. Talk to your pain doctor about the exact time frame.
What is the bottom line with medial branch blocks?
These procedures are very low risk and high reward. They are great at diagnosing the particular facet joint as the source of an individual’s pain, while at the same time, offering 2 to 4 months on average of exceptional facet joint related pain relief.
The Florida Pain Network connects those in pain in Florida with pain management providers across the state. This includes pain clinics in Orlando, pain management clinics in Fort Myers, West Palm Beach, Port St. Lucie pain management and more.
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