Medial Branch is a procedure which causes a temporary interruption of the nerve supply to a facet joint. This interruption, known as a nerve block, is accomplished by a tiny needle placing local anesthetic on two small nerve branches that provide the nerve supply to each facet joint. These nerves are called the medial branches.

This procedure is a follow-up to a Medial Branch Block. Once the source of your pain is isolated with MMB, this Radiofrequency Rhizotomy will provide an extended period of pain relief.

Frequently Asked Questions About Medical Branch Block

Who will perform the medial nerve block and how is it done?
This simple and fast nerve block will be performed by a pain medicine specialist trained in chronic pain therapy and assisted by a trained clinician.  With fluoroscopic guidance, an extremely thin needle is advanced to the target zone. The needle is placed in close proximity to the medial branch.

Hoe long does it take?
It will take less 5 minutes for the actual procedure.

What should I expect?
You will be prepped and taken to a procedure room. You will be positioned lying on your stomach and the area of focus will be cleansed with a sterile solution. The number of sticks depends on the span of the painful area. Many describe a momentary burning or stinging sensation followed by gradual pressure as the tip of the needle is advanced through the deeper tissues under continuous fluoroscopy (x-rays). Once the placement has been accomplished, you will only feel a slight tightness, pressure or tingle, as the anesthetic substance is placed around and onto the nerve.

Will it work immediately?
Most will experience patient experiences the pain relief. Vigorous physical therapy is necessary to try and strengthen the involved joints. Most will experience significant relief within the first half an hour.

A flow-sheet will be given to the patient with the request to mark pain scores on a scale from 0 to 10 every hour on the hour starting 30 minutes from the completion of the procedure.

While we encourage maintaining a typical rate of activity during this interval, if your pain has decreased  we recommend attempting some minor exertion or movements which would otherwise have been painful and noting if the procedure enabled a better tolerance to these activities.

How should I prepare for the injection?
You may eat lightly before the procedure; ARRANGE FOR A DRIVER TO TAKE YOU HOME. Your procedure will be rescheduled if you do not have a driver; notify the nurse if you are taking blood thinner, aspirin or an anti-inflammatory or have an infection or are sick; stop taking Plavix four days before procedure. When taking Coumadin, blood will need to be drawn prior to procedure to make sure it is not too thin; DO NOT TAKE ANY PAIN MEDICATION THE DAY OF THE PROCEDURE; we need you to have a baseline level of discomfort in order to appreciate the effectiveness of the block. You may take your routine medication the day of the procedure (heart, diabetes, blood pressure); Expect to be at the office one to two hours. This includes registration, paperwork, review of consent, procedure, recovery and review of discharge instructions.

Learn more about the medical branch block injection. Watch Video