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Medial Branch Block – Facet Blocks

Overview

Medial Branch Blocks are similar to facet injections; however instead of injecting into the joint, Dr Morchower blocks the tiny nerves that receive pain signals from the facet joints. These are called the medial branch nerves and they lie right next to the actual joints in the neck, thoracic back and low back. With X-ray guidance (Fluoroscopy), Dr Morchower is able to guide the needle to these nerve and put numbing medication on the nerve. This aids in diagnosing where your pain is coming from.

Who are Good Candidates for Medial Branch Blocks?

Similar to facet joint injections, medial branch blocks can be used diagnostically as well as treat chronic neck and back pain associated with the following conditions:

  • Disc Herniation – In between the vertebrae in our spine, there are gel-like discs that absorb the shock and pressures our spine encounters on a daily basis. If you receive too much impact, like in a fall, car accident, lifting heavy or other major injury, it may cause the disc to slip out, or herniate, out of place. When it protrudes out, it can hit the nerves that run alongside the spine, which can cause pain in the back, neck or extremities.
  • Degenerative Disc Disease (DDD) – DDD is a common condition that comes with age. Again, degenerative disc disease is a natural process of aging. With this process, the disc loses its elasticity and hydration which can cause the disc space to narrow and the disc to tear. This can also be a significant factor in back and neck pain.
  • Spinal Stenosis – Arthritis and other conditions that cause abnormal bony formations and ligament thickening can cause narrowing of the spinal canal where spinal nerves run up and down the spine. This is called spinal stenosis or spinal narrowing. The narrowing within the vertebrae irritates the spinal nerves, causing significant neck, back and/or leg pain. Some people are predisposed to having spinal stenosis. Stenosis is another word for Narrowing.
  • Whiplash – The quick movement and force from whiplash can cause pain in the area of the facet joints of the neck leading to chronic neck, shoulder and arm pain. Whiplash injuries are commonly the result of car accidents and sports injuries.

The Procedure

Medial branch and facet block injections take about 30 minutes to perform. Only a small amount of a long acting anesthetic is injected at each nerve for the block. Prior to the actual block injection, the skin on the back is cleaned and numbed with a local, short-acting anesthetic. Twilight sedation can be used for comfort during this procedure.

The Results

Since medial branch and facet blocks are mostly utilized as diagnostic tests, long term pain relief is not necessarily the goal. The block works more as a predictor for how well treatments such as radiofrequency ablation (Rhizotomy aka Nerve Burn) will work for your pain. Dr. Morchower will often refer to the medial branch blocks as “a test” to determine if you are a candidate for a nerve Rhizotomy.

*Individual Result May Vary*