Medial Branch Blocks

Patients who are experiencing low back and neck pain and who have yet to find relief with conservative treatment methods might be able to benefit from medical branch blocks. Both used as a diagnostic tool and a method for immediately relieving pain, medial branch blocks are a great minimally-invasive treatment option that is an attractive option for many patients. The California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas are experts in medial branch block treatments and have helped numerous patients experience the pain-free lifestyle they’ve been needing and wanting. 

What are Medial Branch Blocks? 

Medial branch blocks (MBB) are a non-surgical and minimally-invasive injection procedure that treats chronic neck and low back pain. 

To understand how the blocks work is to first understand the different parts of the spine. Overall, the spine consists of vertebrae that are cushioned by intervertebral discs that are stabilized by facet joints. Together, these parts help the spine to be strong yet flexible, absorb shock, and twist and flex. The medial branch nerves are located near the facet joints in the spine and carry pain signals from the facet joints to the brain. 

When the facet joints become inflamed or irritated, either due to trauma/injury, wear and tear, or a particular medical condition, pain signals are sent from the joints via the medial branch nerves to the brain, altering the person to the feeling of pain. If the person suffers from chronic pain, the medial branch nerves are always sending pain signals to the brain. Medial branch blocks work to block these pain signals by reducing inflammation and irritation by injecting an anesthetic and corticosteroid near the medial nerves. 

Why are Medial Branch Blocks Used?

In addition to providing immediate pain relief, medial branch blocks also offer two main benefits: 

• When used as a diagnostic tool, medial branch blocks can confirm that the facet joint is the main cause of pain if the patient’s pain is resolved. However, if the pain is still felt after the injection, then the pain management specialist knows that the chronic pain is caused from another location/condition in the body. 
• A positive response to the medial branch block can help the pain management specialist create an accurate treatment plan for the patient. Most often, the next recommended treatment after medial branch blocks is radiofrequency ablation (RFA), which works to provide more long-term relief for chronic pain. 

Medial branch blocks are a great option for patients who have yet to find relief for their chronic pain. The California Pain Consultants team will always recommend the most conservative methods first, with surgery as a last option. So when a patient has possibly tried facet joint injections but didn’t have a positive outcome, a next option could be medial branch blocks, which targets the nerve itself, versus the joint. The spine has an intricate makeup of bones, nerves, tissues and muscles, so it’s important that the precise injection or treatment method is used to target the specific location that is causing chronic pain. 

What Pain Conditions Do Medial Branch Blocks Treat?

Medial branch blocks offer patients who suffer from chronic low back pain with many benefits. The first and main benefit is immediate pain relief. Not only does this allow the patient to finally experience pain-free movements, but also provides the patient with the opportunity to utilize physical therapy and exercises with a goal to extend their period of pain relief. 

Specific medical conditions that medial branch blocks can treat include: 

• Osteoarthritis
• Facet joint pain
• Sacroiliac joint pain
• Rheumatoid arthritis
• Scoliosis
• Degenerative spondylolisthesis 
• Ankylosing spondylitis

While not a specific medical condition, patients who suffer from sciatic pain (also known as sciatica) can find relief for their buttock/hip/leg pain with medial branch blocks, allowing providers to utilize additional therapies while they experience pain relief. 

Due to the fact that medial branch blocks are a minimally-invasive diagnostic and treatment option, they are most often used in the beginning stages of treatment, along with oral medications and physical therapy. However, medial branch blocks are not a suitable option if the patient is pregnant or has bleeding disorders, or there’s active system infection or infection around the would-be procedure site. 

Medial Branch Block Injection Procedure Overview

A medial branch block is a quick and safe procedure performed in a doctor’s office. A patient will lie face down on a procedure table, and the provider will inject a local anesthetic that numbs the skin and tissues near the facet joint. The provider will then use fluoroscopy (an imaging technique) to guide the needle to the exact location near the medial branch nerves, injecting a corticosteroid and anesthetic, which works to provide immediate pain relief and also reduce inflammation around the nerves. 

The entire procedure takes about 15 minutes. Some patients can receive more than one injection, depending on the location of pain. Patients are encouraged to rest for the remainder of the day, but can generally resume normal activities the following day. 

Most patients can expect to enjoy pain relief that begins immediately and can last up to four months. If the medial branch block is successful on all accounts, the patient might opt for radiofrequency ablation for more long-term results. 

Are There Side Effects and Risks with Medial Branch Blocks?

As with any medical procedure, there are side effects and risks involved. However, the side effects associated with medial branch blocks are minimal, and generally include minor discomfort and soreness at the injection site. 

Potential complications involve bleeding and injection at the injection site, and in some rare cases, nerve damage. 

There are potential side effects in regard to the injection medication itself, which include weight gain, arthritis, stomach ulcers, elevated blood sugars and a temporarily less effective immune system. However, the majority of patients who receive medial branch blocks have already been prescribed oral corticosteroids, so the chance of experiencing these particular side effects should be less. 

If you are experiencing chronic neck and low back pain and believe medial branch blocks could help you, please reach out to the California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas and schedule an appointment today. Our team is dedicated to helping all patients live a pain-free life.