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Medial branch nerves are located in your back and neck stemming from your spinal nerve into the facet joins of our spine. Our facet joints can be a significant source of low back pain. This pain is communicated through the medial branch nerves. The facet joints are pairs of small bones in your low back that are crucial to allowing our spine to bend and twist to accommodate our bodies moving. Facet joint syndrome is a painful condition that produces low back pain.
Medial branch blocks deliver anesthetic lidocaine (numbing medication), and sometimes a steroid to the affected nerve to provide immediate relief of the painful low back. The primary goal of the injection is to diagnostically confirm the facet joint as the source of the low back pain. If a patient gets more than 50 percent pain relief from the injection, they are a good candidate for a percutaneous radiofrequency ablation, or an endoscopic rhizotomy to provide further relief. These procedures ablate the medial branch nerve, thus disconnecting the pain signal from your back to your brain.
If you are suffering from chronic low back pain that lasts for more than 12 weeks, and have failed conservative treatments such as over the counter medication, and physical therapy, you could benefit from medial branch block.
The injection is typically administered at the doctor’s office or a surgical center. The procedure is outpatient, least invasive, and takes about 15-30 minutes. Patients can be given conscious sedation of local skin numbing to be comfortable during the procedure. However, the use of sedation is discouraged because this limits ability of patients to perceive effect of the injection. The patient will lie down on the procedure table and the area to be treated will be cleaned, and local anesthetic injected. Using fluoroscopy (real-time X-ray), the doctor will confirm and guide their needle to the affected medial branch nerve of the facet joint to deliver the numbing medication.
Soreness can be expected around the skin injection site for a few hours. You are encouraged to move your neck around to determine the amount relief provided by the injection. Most routine activities and work can be resumed the following day. Pain relief from the cervical facet joint typically begins shortly after the procedure, and the duration of pain relief is typically for about a day.
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