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Medial Branch Block

A medial branch block is a specialized injection procedure used to both diagnose and temporarily relieve chronic spine pain, particularly that which originates from the facet joints in the cervical, thoracic, or lumbar spine. These joints—small structures that connect each vertebra and allow the spine to flex and rotate—are often overlooked sources of persistent neck and back pain. When they become inflamed or arthritic, they can irritate the medial branch nerves that relay pain signals to the brain.

A medial branch block involves injecting a local anesthetic near these small sensory nerves to “block” their ability to transmit pain. If the patient experiences significant relief, even if temporary, it confirms that the facet joints are the source of their pain and helps guide the next phase of treatment, which may include radiofrequency denervation for longer-term relief.

What Conditions Are Treated with Medial Branch Blocks?

Medial branch blocks are most commonly used in patients experiencing axial back or neck pain—meaning pain that stays local and does not radiate into the arms or legs. This type of pain often stems from:

  • Facet joint syndrome
  • Spinal osteoarthritis
  • Degenerative disc disease
  • Whiplash or post-traumatic injury
  • Post-laminectomy or post-fusion syndrome
  • Chronic neck or lower back pain without a clear disc herniation

If you’ve been diagnosed with any of these conditions or are experiencing persistent spinal pain, a medial branch block can be a powerful tool in accurately identifying the source of your discomfort. Learn more about these conditions in our Conditions Treated section.

What to Expect During the Procedure

This outpatient procedure is performed under fluoroscopic (X-ray) guidance to ensure precise needle placement. After cleaning and numbing the skin, a fine needle is guided to the medial branch nerves near the affected facet joints. A small amount of local anesthetic is then injected to interrupt pain signal transmission.

Because the anesthetic typically wears off within hours, patients are asked to monitor their pain levels closely during this period. A significant reduction in pain suggests the facet joints are the source, and the patient may be considered for radiofrequency facet denervation, which provides longer-lasting relief.

Effectiveness and Role in Diagnosis

Though the pain relief from a medial branch block is temporary, the diagnostic value is significant. If no relief is experienced, other sources such as the spinal discs or sacroiliac joints may be investigated. If the procedure is successful, it lays the groundwork for future treatment tailored to the patient’s exact needs.

Multiple medial branch blocks may be performed to cover more than one facet level, particularly in the lumbar spine where several joints may be contributing to pain.

Benefits of Medial Branch Blocks

  • Precisely identifies pain origin
  • Minimally invasive with no downtime
  • Can confirm candidacy for advanced treatments like radiofrequency denervation
  • Reduces reliance on imaging alone for diagnosis
  • Provides temporary relief for pain management

Let Ascent Pain Help You Find Answers

Chronic spine pain doesn’t have to remain a mystery. At Ascent Pain, our team uses advanced diagnostics like medial branch blocks to help you understand what’s causing your pain—and how to treat it effectively.

Call (504) 249-7576 or fill out our appointment request form to take the next step toward accurate diagnosis and personalized relief.