When Procedure is Used
The cause of back pain is often difficult to diagnose, and facet injections, or medial branch blocks, are one way to identify why back pain is occurring in order to treat it. The procedure will likely be conducted after a patient has tried other ways to achieve pain relief such as anti-inflammatory medications and physical therapy.
You will likely not need any anesthesia for a medial branch block, but you may be given something to help you relax. Using fluoroscopy, or guided x-ray, your surgeon will place a small needle into the facet joint and deliver a small amount of numbing medicine around the nerve. After you have been given the injection, the doctor will assess your pain level. If it has significantly decreased, you will know that the nerves in your facet joint are contributing to your pain, which may indicate that you are a good candidate for a rhizotomy, which is a more permanent way to diminish or eliminate back pain. If you benefit from the procedure, the next step would be consideration for radiofrequency treatment of the medial branch nerves. This a procedure that will provide pain relief for a longer period of time.
The effect will last several hours or more. Since this is strictly a diagnostic block to test the source of pain, it is very important for patients to fill out their pain log that they receive following their procedure. Once the aesthetic wears off the pain will likely return and a patient may have some increased soreness for a day or two.
It has become a standard for the insurance coverage that you need to have two medial branch block injections with a certain level of improvement post injection. Only one level will be done at the time with a minimum of 7-10 days between levels.
The risk of complications is very low, however, potential risks might include:
- allergic reaction to medication
- minimally invasive diagnostics