Medial Branch Block

Medial Branch Block

A medial branch block is a diagnostic procedure used to evaluate whether a patient’s pain is related to a facet joint in the back. Generally, an injection of an anesthetic and steroid combination for pain relief is first tried on the facet joint. If the patient still suffers pain after this procedure, a medial branch block is the next step.

If the medial block eliminates pain, the patient may receive long-term relief from another procedure known as a medial branch radiofrequency neurotomy.

Medial Branch Nerves

The medial branch nerves move out from the spine’s facet joints, carrying pain signals from these joints to the brain. The medial branch block consists of an anesthetic injection into the medial branch nerves of a specific joint. The block should temporarily stop the nerves from sending pain signals from the facet joint.

Medial Branch Block Procedure

Patients receiving a neck injection should fast for at least six hours prior to the medial branch block procedure. They should ask the doctor about any eating or drinking restrictions for a back injection. Some patients chose IV sedation for the process, while others are fine with the standard local anesthetic at the injection site.

The actual procedure consists of the injection, so it is relatively brief. The patient either lies on their side for a neck injection or on their stomach for a back injection.

Most patients will find relief within a few hours of the injection. If there is no relief, it is likely that the medial branch nerves were not causing the pain. Remember that this is a diagnostic procedure, not an actual “cure” for pain. When patients find pain relief, they are good candidates for radiofrequency treatment of the medial branch nerves.

Patients with extremely high blood pressure, on blood thinners or dealing with an active infection cannot undergo a medial branch block. The same holds true if the patient is currently battling a cold or flu or is running a fever.


Patients must arrange for transportation home after the injection. It is not safe for them to operate a vehicle.

While patients may resume normal activities within a day or so, some precautions are necessary. They should not take a bath, shower, or otherwise get the area wet for 24 hours. They should also avoid any type of heat in the area for the same time.

Potential Side Effects

Most side effects from a medial branch block are rare but can happen. Temporary discomfort at the injection site is common. Some patients experience weakness or numbness. A small number of patients develop a minor infection at the injection site.

In an even smaller percentage of patients, the medial branch block increases the pain. Should any uncommon side effects occur, call your doctor immediately.

Pain Relief

Because a medial branch block is a diagnostic procedure, it is imperative for patients to keep track of their pain levels. They should keep a diary, either written or electronic, of the degree of pain experienced for the next few weeks.

In most cases, pain relief from a medial branch block subsides after several weeks, although some patients may feel better for a longer time.

Contact A Doctor

Your Elite Spine & Orthopedics physician will know if this injection is right for you. Contact us to make an appointment: (855) 77-SPINE.