Medial Branch Blocks (MBB)

Medial Branch Blocks (MBB)

(Cervical and Lumbar)

Medial branch nerves are very small verve branches that carry the pain message from the facet joints and the muscles around the joints. If the nerves are blocked or numbed, they will not be able to transfer the pain sensation from the joints to the brain.

Frequently Asked Questions

Where are the facet joints?
The facet joints are small joints in the back of the spine that form connections between each vertrebra. Each vertebra has a surface on four facet joints, two on the upper or superior surface and two on the lower or inferior surface of the vertebra. The facet joins limit how far you can twist or bend your back and neck.

What is the purpose?
This is a diagnostic procedure. This is injection is done to confirm the diagnosis of facet joint disease and to find out if the facet joints are contributing to your pain.

How is the injection performed?
The patient lies on his/her stomach. The skin of the back is cleaned with antiseptic solution and is injected with local anesthetic, after which the nerve block is performed under X-ray guidance.

How much time does the procedure take?
The procedure usually takes 5 to 10 minutes.

What medicine is injection?
A local anesthetic such as Lidocaine is injected.

Will the injection hurt?
The procedure is performed under local anesthetic, which is used to numb the skin and deeper tissues.  You may feel a burning sensation that will last only a few seconds from the local anesthetic and some pressure but typically not much pain.

How will I feel after the injection?
You may have a sore back briefly after the injection because of the medication that was injected but then you should feel some relief. Using an ice pack for 20 minutes a few times that day will help with this.

How long does the effect of the injection last?
If the facet joints are the source of the pain, you should benefit from the injection relatively quickly.  Because this is a diagnostic injection, it is not intended to last, however it may last several hours to several days. Every patient is different.

What is the next step after having good relief?
If you benefit from the procedure, the next step would be consideration of radiofrequency ablation of the medial branch nerves. Typically, two diagnostic tests are required before moving on to the radiofrequency.

What are the side effects of the injection?
Serious side effects and complications are uncommon. The most common problem after the injection is having pain in the area of injection for a few days. The other compilations are injection bleeding, and nerve injury.

Who should not have the injection?
If you are taking antibiotics or if you have any active infection, especially in the area being worked on, you should not have the procedure without further discussion.  Also, please warn us of any allergies, especially to local anesthetics, x-ray dye, seafood, and latex.