Back Pain

Lumbar Medial Branch Block

A Lumbar Medial Branch Block is a diagnostic procedure used to identify painful facet joints in the lumbar spine commonly seen in Facet Joint Arthritis.  Medial Branch Nerves innervate facet joints and pick up pain signals from these joints.  During this procedure, an anesthetic will temporarily block sensation in these nerves to determine whether the facet joints are responsible for causing the patient’s symptoms.

During the procedure, the patient lies on their stomach with a pillow placed under the stomach for comfort.  The physician uses a live X-Ray machine called a fluoroscope to locate the appropriate facet joints.  A small amount of local anesthetic is used to numb the skin to keep the patient comfortable throughout the procedure.  With the guidance of the fluoroscope, the physician carefully guides the needle to the outside of the facet joint directly over the Medial Branch Nerve.  A small amount of anesthetic is applied to the nerve to block it. The needle is removed, and a small band-aid is applied.

Following the procedure, the patient resumes normal activities to determine whether low back pain is reduced for the 6-8 hours following the injection while the medial branch nerves are still blocked.  If there is significant pain relief, the patient is considered for Radiofrequency Ablation of these same nerves to provide relief of low back pain for 6-12 months.  The patient may also be a candidate for PRP therapy or Bone Marrow Concentrate (BMC) treatments to the facet joints to stimulate healing.