Medial Branch Block Injections

A medial branch block injection is a diagnostic procedure which involves injecting local anesthetic, under x-ray guidance, into the nerve that supplies the facet joints. This nerve is called the “medial branch” and its only job is to supply the facet joint with sensation. When the facet joint is injured, degenerative or inflamed it is this nerve that creates the pain. The doctor injects local anesthetic onto the “medial branch” nerve that supplies the facet joints that they suspect are causing the pain, essentially ‘blocking’ the nerve temporarily.

If the symptoms resolve for the duration that the local anesthetic is working, we know we have succeeded in locating the source of the pain and can move forward with a longer term treatment plan of Radiofrequency denervation to provide long term relief for facet joint symptoms. Research shows that patients who respond well to these diagnostic injections are more than 80% likely to respond to denervation treatments. This evidence, showing an improvement in function and reduction in painful symptoms, make it a popular treatment choice for many of our patients!

We can do this procedure for the lumbar or cervical facet joints. We can do it one side or both, and at either one or multiple levels depending on which joints the doctor suspects the pain is arising from.

At your initial consultation, the doctor will take time to understand your symptoms and undertake a thorough assessment to ensure the injection is right for you. It is important to let the doctor know of any known allergies, such as plasters and to inform us if you are pregnant. Please also let the doctor know if you have any medical conditions and take any regular medications including blood thinning medications. This is also a great opportunity to ask the doctor any questions you may have about the procedure.

Before having your treatment eat and drink as normal, including taking any regular medication (unless otherwise advised by the doctor, e.g. blood thinning medication) and wear loose comfortable clothing

The doctor will explain everything to you before your procedure and ask you to sign a consent form to confirm that you are happy to proceed.

All spinal injections are performed using our high-tech fluoroscopic x-ray for guidance and precision, by using this image guidance for accuracy and safety, the doctor can be confident the injectate is being delivered to the desired location.

Local anaesthetic is used on the injection point to make the procedure as comfortable as possible for you. After this has been done, a needle will be inserted adjacent to the medial branch nerve, once the position has been confirmed a small volume of short and long acting local anaesthetic will be injected into the nerve.

In the majority of cases this is not a painful procedure, some patients may experience a reproduction of their symptoms, however if the diagnosis is positive the pain should resolve within 10 minutes, confirming the facet joint as the source of the pain.

The injection of local anesthetic should cause your symptoms to resolve for approximately 3-12 hours depending on the anesthetic used (the doctor will inform you of this).

Keep a pain diary

You will be given a pain diary to record the effect of the injection on your symptoms for the next 24 hours. A reduction in symptoms during the time that the anesthetic is working is an indication that the correct facet joint has been targeted and this allows the doctor to discuss the option of Radiofrequency Denervation for longer term relief.

It is expected that your symptoms will return after 6-12 hours when the anesthetic has worn off.

All of our spinal injections are carried out by experienced consultant doctor Tom Saw