Lumbar Medial Branch Block
If you suffer from chronic low back pain that has failed to respond to treatment, this simple, diagnostic procedure can pinpoint the source of your pain in order to determine the most effective course of action.
What is a Lumbar Medial Branch Block?
Inflammation of the small joints between spinal bones called facets can cause neck pain, mid-back pain and/or low back pain. A medial branch block is a procedure that can not only determine which facet joint in the back is causing pain, but can also be effective at eliminating that pain at the same time.
A medial branch block is an injection of medication outside the joint space near the nerve that feeds a specific joint. If pain is relieved, it could mean the facet joint that is generating the pain has been identified.
Facets are small joints located throughout the spine, including the lower back (lumbar spine). They can easily be injured by common activities, sports, or even a car accident. To date, there is no form of imaging (not even MRI) that can definitively locate the facet that is causing pain – a lumbar medial branch block is the only way to identify the offending facet.
This procedure is used to diagnose what part or parts of the spine are causing back pain. Facet joint pain is a common cause of lower back and buttock pain that is usually overlooked. A lumbar medial branch block is currently the most effective means of finding the source of the pain.
A lumbar medial branch block involves numbing the small nerves outside the facets called the Medial Branches – these nerves communicate pain from the facet to the brain. By blocking that signal, your doctor can find out which facet joint is causing the pain.
The procedure is an easy, minimally-invasive means to diagnose exactly where the back pain is being generated and potentially treat it – all at the same time. If the procedure works and the patient reports a reduction of pain, the doctor may choose to administer the block again. This is to make sure the pain relief was not coincidental, or maybe the result of the medication escaping the joint and working on a different part of the neck or nearby nerve.
If relief is short-lived, your doctor may recommend another procedure called Radiofrequency Ablation (or RFA). RFA works by applying complex radio waves to the medial branches instead of an injection. This may provide more effective and longer lasting pain relief to the joint.
Typically 2 treatments are indicated.
Is a Lumbar Medial Branch Block Right for Me?
If you suffer from back pain that has failed to improve, it may be because the culprit generating the pain has never been successfully identified. A lumbar medial branch block may be an effective option for you to finally find out the cause. This procedure should be performed under the strict supervision of a board-certified pain management specialist.
Contact the Ainsworth Institute to set up an initial evaluation to find out if you are a candidate for a lumbar medial branch block.
Before the Procedure
Patients will get specific advice prior to the procedure. In general, patients will be advised to:
• Stop blood thinners about two days before the test.
• Stop aspirin and anti-inflammatory medications about five days before the test.
• Stop pain medication about eight hours before the test.
Patients will be asked to stop eating and drinking about six hours before the procedure. Although facet and medial blocks are often administered as outpatient procedures, the patient should arrange for someone to drive him or her home after the test.
Procedure - Patient Details
The procedure is performed in a sterile setting similar to an operating room. The injection site is cleaned and draped. Numbing medication is injected into and around the procedure site.
The procedure is observed on fluoroscopy, a kind of video X-ray that projects images on monitors in the operating room. The fluoroscope’s C-arm, named for its characteristic C-shape, will be positioned over the patient.
Diagnostic injections may include an anesthetic, steroid, and/or antibiotic. The goal of a diagnostic injection is to relieve the patient’s symptoms. During the procedure, the physician may ask for feedback from the patient.
A medial branch block, like other medical procedures, may present risks. Rare but possible complications include risk of infection, low blood pressure, headache, and injury to nerve tissue.
The Ainsworth Institute is Here to Help
If you are suffering from back pain that has failed to respond to treatment and would like to see if you may be a candidate for this exciting treatment option contact the Ainsworth Institute of Pain Management today. Schedule an appointment with one of our Board Certified Physicians to learn more about a lumbar medial branch block and see if you are a candidate for treatment.