What is the Next Step After a Medial Branch Block?

When creating a chronic neck or back pain treatment plan, your healthcare provider may suggest exploring medial branch blocks. These can help identify the source of pain along the spinal column and pinpoint the best treatment to relieve long-term pain.

The pain specialists at Advanced Spine and Pain use various treatments to help relieve neck and back pain, including medial branch blocks. We can help you sort out your options. If you are considering a medial branch block and want to learn more, call us today at 480-573-0130
or contact us online.

If you’re wondering what the next step is after a medial branch block, this article will explain what you can expect.

What is a Medial Branch Block?

A medial branch block is an injection performed near the medial branch nerves in the spinal column. Inflammation or injury to the joints in the spine, called facet joints, causes these nerves to transmit pain signals to the brain. The pain signal is blocked by injecting a local anesthetic and sometimes a steroid medication near these nerves.

Why Choose a Medial Branch Block?

Problems at the facet joints account for up to 45% of cases of back pain¹ and 42% of cases of neck pain. If your pain specialist or another healthcare provider suspects that your facet joints are the source of your pain, they may recommend a medial branch block.

Medial branch blocks are considered diagnostic injections² that are used to confirm that the pain is coming from the facet joints. The pain relief from a medial branch block is only temporary, so it’s essential to follow the next steps recommended by your doctor.

What is the Medial Branch Block Recovery Time?

Medial branch blocks are minimally invasive with a low risk of side effects, and the recovery time is usually very short. You can return home the same day as the injection, and any discomfort from the injection should improve quickly.

Medial Branch Block Recovery Tips

After a medial branch block, it is usually recommended that you rest for 24 hours and avoid strenuous activity. If you experience increased pain, swelling, drainage from the injection site, or problems with numbness that spreads or affects movement, you should contact your doctor immediately.

What is Next After a Medial Branch Block?

After a medial branch block procedure, the next step depends on the outcome of the injection. Your doctor may advise you to return for a second medial branch block to confirm the results of the first one. Some key points to consider:

What if a medial branch block doesn't work?

Medial branch blocks can temporarily relieve pain if the source is the facet joints. If it doesn’t work, the source of your pain may be something other than facet joint pain or dysfunction.

What if a medial branch block is effective?

For those who have pain relief following a medial branch block, it is essential to follow up with your healthcare team to determine a long-term plan to manage your facet joint pain. Medial branch blocks usually only last a few hours to days.

Treatment options after a medial branch block

There are several treatments³ that can be effective long-term for facet joint pain:

• Radiofrequency ablation (RFA): this can stop nerve endings from transmitting pain signals long-term.
• Facet joint injections: similar to medial branch blocks, these injections in the joint (instead of near the medial nerves) relieve pain for longer periods.
• Spinal manipulation: to realign parts of the spine and help increase range of motion.
• Physical therapy: often used in combination with other treatments, physical therapy exercises can increase strength and stability around affected joints.
• Medication management: to help improve pain relief and support recovery and treatments like physical therapy and spinal manipulation.

Interested in Learning More About Medial Branch Blocks?

If you're considering medial branch blocks to diagnose the source of your back or neck pain, the Advanced Spine and Pain expert team can help you explore all options for facet joint pain and other spine issues, creating a tailored plan for optimal relief.

Contact us today to learn more, or call us at (480) 573-0130.

References

1. Manchikanti, Manchikanti, K., Cash, K., Manchikanti, L., Ba, Singh, V., & Giordano, J. (2008).
   Retrospective Evaluation Age-Related Prevalence of Facet-Joint Involvement in Chronic Neck and Low Back Pain.
   Pain Physician, 11(1), 67–75.
   
   https://www.painphysicianjournal.com/current/pdf?article=OTQ1&journal=39
   
2. Bartleson, J. D., & Maus, T. P. (2014). Diagnostic and therapeutic spinal interventions: Facet joint interventions.
   Neurology: Clinical Practice, 4(4), 342–346.
   
   https://doi.org/10.1212/cpj.0000000000000044
   
3. Su, D. C. J., & Chang, K.-V. (2020). Facet Arthritis. PubMed; StatPearls Publishing.
   
   https://www.ncbi.nlm.nih.gov/books/NBK493233/