Diagnostic Medial Branch Blocks
- Each level of the spine is connected to its neighboring level by a facet joint. Each facet joint is fed by two small branches of the larger spinal nerves. Facet joints can be a significant source of pain in several types of patients, especially those with a history of trauma, degenerative disc disease, or advanced arthritis. When other structures in the spine become weak, the facet joints often become hypertrophic or enlarged. Physical examination and imaging studies can suggest a diagnosis of facet joint pain, but for a more definitive diagnosis and treatment, an injection may be required. Anti-inflammatory steroid and local anesthetic can be injected directly into the facet joints to produce dramatic pain relief. If an injection directly into the joint does not provide sustained relief, or your medical history precludes repeated steroid injections, a medial branch block can be performed.
A medial branch block is an injection of local anesthetic near the two small nerves that feed a particular facet joint. Typically several levels are injected at once. If dramatic (or greater than 50%) pain relief occurs while the local anesthetic is active (typically several hours), then a diagnosis of facet joint pain can be made. Confirmatory tests may be required.
These blocks are used by us to both confirm our diagnosis and zero-in on the exact level that is generating your pain. This will help to determine what levels to treat during a medial branch Rhizotomy or Denervation.