Cervical, Thoracic, Lumbar Medial Branch Block

A medial branch nerve block is a diagnostic procedure that can help determine the exact source of a patient’s pain. During the procedure, anesthetic is injected into the small medial nerves that connect to particular facet joints in the spine. If a patient experiences a significant reduction in pain immediately after the procedure, they may be a viable candidate for a medial branch radiofrequency neurotomy which provides longer-term pain relief.

A radiofrequency neurotomy, also known as an ablation, is a procedure which creates a heat lesion on the nerve responsible for transmitting pain signals to the brain. The goal of the process is to interrupt the pain signal without causing a loss of sensation or muscle weakness.

Cervical facet joint pain is often the result of some form of joint dysfunction, an injury or some other type of irritation. The pain stemming from an irritated cervical facet joint can manifest as muscle tension, or it can escalate to severe pain and discomfort. Where the pain radiates from is dependent upon which joint has been affected. Typical pain presents from the head down into the shoulder blades.

The Cervical Medial Branch Nerves are located in a bone groove in the neck. The small nerves are tasked with sending pain signals from the cervical facet joints to the brain. During the treatment of cervical facet joint pain, an anesthetic is injected over the patient’s cervical medial branch nerves to stop pain signals transmitted from the facet joint temporarily. The procedure involves using fluoroscopy x-ray techniques to guide a thin needle directly into the facet joint. A dye may also be injected to assist positioning the needle correctly.

If the patient’s symptoms subside, then the provider can confirm that the joint is responsible for the discomfort.

Medial Branch Blocks inject a local anesthetic near the medial branch nerve, which has the effect of stopping the transmission of pain signals from the facet joint. This well-known procedure is an outpatient procedure for the treatment of lower back, buttock, hip, groin, neck pain, and headaches.

In the course of the procedure, the physician will determine which facet joint(s) have been causing your pain. After that, to numb your skin, a local anesthetic may be used.

To ensure the safe and proper position of the needle, the physician uses a special type of x-ray called fluoroscopy. The x-ray allows the physician to verify the correct placement of the needle before injecting the Medial Branch Block.

After determining how long the pain will be relieved, then another procedure may be introduced which is called Radiofrequency Ablation. RFA is a procedure which provides a long-term disruption of pain signals. You may be a candidate for RFA if your pain disappears for a short time (meaning even a day or less) but eventually returns.

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