Medial branch blocks (MBBs) are minimally-invasive, diagnostic nerve blocks that help determine if pain is coming from the joints of the spine, also known as the facet joints. The facet joints in the spine transmit pain signals to the brain by the medial branch nerves. By blocking these nerves with local anesthetic medications, pain sensation of the facet joints will be rapidly relieved. This will inform your physician if your pain is truly coming from the facet joints and will allow your therapy to be specifically targeted to these joint levels. The procedure can be performed at any level of the spine, including the cervical, thoracic, and lumbar spine, and is very successful in the treatment of chronic arthritis-related neck and back pain.
Facet-mediated pain typically occurs at multiple joint levels and is often on both sides of the spine. Your physician will likely perform the medial branch blocks on one side at a time so that the pain relief can be isolated to that side and compared to the untreated side. The procedure is limited to two or three joint levels and is often repeated to yield the greatest diagnostic information. If the patient experiences successful pain relief from these blocks, a long-term treatment option, called a radiofrequency ablation (RFA), can be performed. This treatment will result in the same pain relief experienced with the medial branch block, but the pain relief will last for at least 6-9 months, with many patients experiencing pain relief for 12-18 months or more. The medial branch blocks will not need to be repeated once an RFA is performed, but the RFA can be repeated, should a patient’s pain return in the future.
The procedure takes less than 15 minutes to perform. Patients are encouraged to resume their normal activities after their procedure to better determine how successful the block was in producing pain relief. Risks of medial branch blocks are extremely rare, but include bleeding, infection, and nerve damage. Multiple, large evidence-based studies have shown medial branch blocks and radiofrequency ablation to be among the most successful procedures in the diagnosis and treatment of chronic joint pain in the spine.