MBBs are the MVPs: Medial Branch Blocks for Chronic Back Pain

What Are Medial Branch Blocks? 

Medial branch blocks are a form of pain management used to target chronic pain, primarily in the lower back; however, they can be used to treat pain along the entire spine and neck. For a medial block branch, a small amount of anesthetic is injected into the space outside of a spinal joint, called a facet joint, near the nerve that runs into it. This nerve is called the medial branch. The anesthetic then blocks the transmission of pain signals from the targeted nerves. This should create almost immediate pain relief in the facet joint.  

The Applications of Medial Branch Blocks

Medial branch blocks are primarily used to treat pain that has developed from inflammation or damage to facet joints in the spine. Medial branch blocks can also target facet joint pain caused by arthritis, trauma, or an injury. Typically, candidates for medial branch blocks suffer from long term, localized back pain and have not benefited from conventional therapies and conservative treatments. The duration of the relief varies from patient to patient and depends upon the anesthetic used, as well as if it was combined with a steroid injection. If successful, pain relief is usually immediate and may last a few hours to a few days; however, in some cases patients may experience relief for up to a few months.    

Medial branch blocks are also used as a diagnostic tool, allowing providers to better identify the source of a patient’s chronic back pain. This identification depends upon whether or not the pain is alleviated as well as the duration of this relief. If a patient experiences pain relief after this procedure, he or she may be a good candidate for radiofrequency ablation. Radiofrequency ablation (RFA) is a longer lasting treatment that uses radio waves to heat and create lesions in the sensory nerves responsible for sending pain signals. In RFA, radiofrequency waves are sent from a probe into the surrounding tissue, causing the nearby cells to die. In the case of chronic back pain, the RFA procedure targets the nerve fibers responsible for sending pain signals along the spinal cord to the brain. Medial branch blocks are necessary to confirm the appropriateness of this more long-term treatment by determining if the nerves in question are in fact problematic.  When used after the appropriate diagnostic testing, approximately 70% of patients experience pain relief that lasts for half a year or more from RFA. 

How Does the Procedure Work?

During the procedure, the needle will be placed near the affected joint and nerves. The physician will likely use x-ray guidance in order to ensure the correct placement of the needle. Once the appropriate placement is confirmed, the local anesthetic will be injected. This often provides near immediate pain relief. The entire procedure takes approximately 30 minutes and has no required downtime. If the patient experiences lasting pain relief, the medial branch block can usually be repeated to continue treatment of chronic back pain. If a medial branch block is being used diagnostically and a patient is determined to be a candidate for radiofrequency ablation, the medial branch block procedure will be performed a second time as well to confirm pain relief and that the correct region has been located.  

Often, a steroid is injected in combination with an anesthetic to increase the duration of pain relief experienced by the patient. The steroid and anesthetic are injected directly into the target region. The anesthetic provides immediate relief while the steroid reduces inflammation and helps control pain over a longer period of time.  

MBBs are the MVPs

Medial branch blocks are noninvasive, allow patients to avoid or delay the complications and expenses of invasive surgery, and come with few long term risks or lasting side effects. The procedure takes approximately 30 minutes and has no required downtime. If successful, many experience pain relief almost immediately after the procedure. Furthermore, medial branch blocks provide useful clinical information that can better allow a physician to determine the cause of a patient’s chronic back pain. With this in mind, additional treatment options may then be explored in the future.  

If you are suffering from medial branch blocks for chronic back pain  and wish to explore the diagnostic and treatment benefits of medial branch blocks, contact Ospina Medical today and schedule your consultation! 

Written By: Ashley Knebel

Edited By: Camden Rowe