Back and neck pain can stem from a number of sources inside and around the spine. The medial branch nerves are small nerve endings that provide sensation to the facet joints in the spine.
Facet joints are found in pairs on each vertebral level of the spine and are a very common source of chronic pain. The facet joints enable movement of the spine and can become arthritic due to trauma or the normal aging process.
When the facet joints are suspect, your physician may elect to perform a diagnostic procedure called a Diagnostic Medial Branch Nerve Block. This procedure temporarily blocks pain signals emitted by the nerves of the offending facet joints from reaching the brain.
This procedure can be performed at any level of the spine, including the cervical, thoracic and lumbar regions. The procedure is performed on an outpatient basis under sedation for your comfort and usually takes between 15 to 20 minutes. While lying face down on a table, the skin is cleaned and numbed with anesthetic. Your physician uses a fluoroscopic X-ray machine to help guide the needle to the area around the nerves.
Next, an injection of local anesthetic, which may include a steroid medication, is administered to each targeted nerve. Steroid medications work by decreasing the inflammation that is causing the pain. If there is an insufficient amount of pain relief from the first injections, additional levels within the spine may be treated until the specific levels causing the pain are determined.
After the procedure, you will be monitored for 15 to 30 minutes as you recover from the sedation. You will need someone to drive you home. Your pain may return as the anesthetic wears off while the steroid medication takes 24 to 48 hours to begin to relieve the pain.
The effects of the injection vary from patient to patient, but can last several months or longer. If you report significant pain relief, your physician may recommend a radiofrequency treatment of the medial branch nerves, also called a Rhizotomy, to obtain long-term pain relief.