Medial Branch Block
A medial branch block is both a diagnostic and therapeutic procedure that involves injecting local anesthetic onto the medial branch nerves that innervate the facet joints. If the patient experiences significant pain relief, it confirms the facet joint as the pain source and supports consideration of radiofrequency ablation.
What Is It & Who May Benefit?
A medial branch block is both a diagnostic and therapeutic procedure that involves injecting local anesthetic onto the medial branch nerves that innervate the facet joints. If the patient experiences significant pain relief, it confirms the facet joint as the pain source and supports consideration of radiofrequency ablation.
Symptoms
- Diagnosis of facet joint-mediated pain
- Pre-RFA confirmation
- Cervical, thoracic, or lumbar facet syndrome
- Post-whiplash chronic neck pain
- Post-fusion adjacent segment pain
How It's Performed
Patient positioned prone (lumbar/thoracic) or lateral (cervical)
Fluoroscopic guidance identifies target medial branch nerve
The nerve lies at the junction of the transverse process and superior articular process
Sterile preparation and local anesthesia
22-25g needle advanced to target bone
Small volume (0.3-0.5 mL) of local anesthetic deposited
Contrast confirms spread along the nerve
Validating block: separate session with different anesthetic
Risks & Complications
- Post-procedural pain
- Infection (<1%)
- Bleeding
- Allergic reaction
- False positive/negative results
Benefits
- Confirms facet joint as pain generator (>80% sensitivity)
- Therapeutic relief lasting hours to days
- Guides treatment decisions (RFA candidacy)
- Minimally invasive with rapid recovery
- Reduces unnecessary procedures
Recovery
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Is This Procedure Right for You?
A thorough clinical evaluation is essential to determine whether medial branch block is appropriate for your specific condition.
Dr. Shahnawaz F Shah