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Medial Branch Nerve Block

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Learn more about medial branch nerve block at King Edward VII’s Hospital

What is a medial branch nerve block?

A medial branch nerve block is a type of injection administered to a specific area of the neck or back that allows doctors to ascertain where your neck or back pain is originating from. The injection contains two drugs – a steroid drug that helps to reduce inflammation and swelling, and an anaesthetic that helps to numb pain.

Why would I need a medial branch nerve block?

If your neck or back pain is causing you considerable discomfort, you may benefit from having this procedure. A medial branch nerve block will help your specialist  determine if  the pain is coming from your facet joints.

It can be helpful if you have osteoarthritis or another condition that’s affecting the facet joints causing wear and tear or inflammation.

What symptoms does a medial branch nerve block address?

Your spine is made up of small bones that are joined together by pairs of joints called the facet joints. The facet joints give your spine stability and allow freedom of movement.

If you have a medial branch nerve block and it relieves pain, it means that the pain was originating from your facet joints. Pain relief  may only be temporary, but if you do experience relief from your symptoms, then your doctor will discuss your next course of action to help relieve your pain on a more permanent basis.

When should you speak to a specialist about having a medial branch nerve block?

If you have severe, persistent neck or back pain, speak to your doctor about pain relief and being referred to a specialist who can discuss the possibility of a medial branch nerve block with you.

How is a medial branch nerve block performed?

This kind of procedure is usually carried out as a day case procedure, meaning that you’ll be allowed home the same day. Your specialist will administer a local anaesthetic to numb the skin  and  sedation to make you comfortable and sleepy prior to carrying out the procedure.

Your doctor will use  x-ray images or sometimes a CT scan to help guide them to the precise area that requires treatment. They will then inject the anaesthetic and steroid mix into the area, temporarily disabling the nerves that send pain signals to your brain.

The entire procedure will take around 30 minutes.

What is the recovery like for a medial branch nerve block?

Your recovery from having a medial branch nerve block will depend on multiple factors, including your age, fitness level and the nature of your procedure.

Whilst you’re recovering,, you may feel some weakness or numbness in the treated area and/or your legs. You will need someone to drive you home from hospital and stay with you on the first night.

A medial branch nerve block is usually given so specialists  have a better idea of where the  patient’s pain is coming from and the results are difficult to predict. If you have no relief from your symptoms after having a medial branch nerve block, it’s unlikely your pain was originating from your facet joints. In this case, your  specialist will discuss  next steps with you, which may include repeating the procedure so as to be sure.

If, however your pain relief is significant, then your  specialist may suggest you have a further procedure, called  radiofrequency denervation to help you experience more long term pain relief.

Are there any risks/complications associated with having a medial branch nerve block?

As with any medical procedure, it’s possible for risks or complications to arise. Speaking with your specialist beforehand will help you avoid any adverse reactions.

A medial branch nerve block has a relatively low risk of serious complications happening, but the following risks and complications can occur in a small number of cases:

  • Damage to the nerves
  • Long term weakness or numbness in the area
  • An infection at the treatment site
  • Bleeding from the treatment site

Possible side effects from the steroid medication can also occur, which means you may suffer short term facial flushing, increased appetite, stomach upsets or a rise in blood pressure..

Where can I learn more about a medial branch nerve block?

It’s best to talk to your  specialist about having a medial branch nerve block, but there are also online resources including NHS sources that can provide you with additional information.

How can I prepare for a medial branch nerve block?

Prior to a medial branch nerve block, your surgeon will discuss with you how best to prepare, as each patient is different.

Common preparations for a medial branch nerve block include:

  • Routine blood tests, x rays or scans as requested by your surgeon
  • Taking steps to stop smoking if you smoke
  • Losing weight if you’re overweight
  • Remaining active and doing regular exercise

The specialist will advise you on eating and drinking restrictions prior to the injection

Are there alternatives for a medial branch nerve block?

Your specialist  may decide that you may benefit more from a similar procedure called a facet joint injection.


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