The medial branch nerves are the nerves that send out pain signals from the facet joints to the brain. A facet joint connects two or more bones. In the spine, the joints connecting each vertebra are facet joints; oftentimes, these joints are the source of back pain.
What is Medial Branch Nerve Block?
A medial branch nerve block is a procedure where long-acting, local anesthetic medication is injected near the medial nerves that connect a facet joint. This facet joint injection is typically introduced to several areas of the spine in a singular procedure.
This process is used as a diagnostic procedure. If there is significant pain relief, then a secondary procedure may be recommended. The secondary procedure is known as radiofrequency ablation.
How Long Does a Medial Branch Block Last?
Once the medial nerves have been blocked with an anesthetic most patients experience numbness in the injected area. This numbness allows for immediate pain relief and the relief is intended to last anywhere from 8-24 hours.
If relief is found, it reveals to the provider that the facet joints are the sources of your increased pain. Relief is seen as a positive response to the block. Next, the provider may suggest a radiofrequency ablation for long-term relief.
What is Radiofrequency Ablation (RFA)?
Radiofrequency ablation is often called a radiofrequency neurotomy. This is a type of injection procedure where an electric current is introduced to the nerves of the facet joints. The goal is to disrupt the pain signals that are being sent to the brain.
This procedure is performed by injecting small probes into the affected area. The goal is to decrease the pain signals that the nerves are transmitting to the brain. During the procedure, patients have the choice of mild sedation or taking a prescribed medication before the appointment for comfort.
How Long does RFA Last?
It can take up to six weeks before pain relief may be noticeable. This is due to the nerve irritation that was caused by the procedure. Pain relief can last anywhere from 8 months to several years.
Once the RFA effects begin to wear off, the pain will slowly begin to increase throughout 2 to 3 months. Patients must wait a minimum of 6 months before they can repeat the RFA procedure for continued pain relief.
Most Common Side Effects
As with any procedure, there are risks and side effects with a medial branch nerve block. Listed below are the most common to least common side effects.
- Burning at Injection Site (Common)
- Numbness at the Injection Site (Common)
- Allergic Reactions (Rare)
- Bleeding Complications (Rare)
- Infections (Rare)
RFA is a minimally invasive procedure and is considered low-risk. Typically when an allergic reaction occurs it is due to the x-ray contrast that is used.
Bleeding complications are rare and have only occurred in patients that have had an underlying bleeding disorder. Infections do happen but not often. Mild infections have occurred in less than 2% of patients and severe infections in approximately 0.001% of patients.
Pain Management with Arizona Pain and Spine Institute
At the Arizona Pain and Spine Institute we are excited to offer cutting-edge treatments. One treatment is the use of amniotic fluid-derived regenerative medicine stem cells. These stem cells restore damaged soft tissues and provide an additional anti-inflammatory effect.
If you are experiencing chronic pain, our team of highly skilled professionals may be able to help. We are committed to improving our patient’s quality of life and to helping them live pain-free. Contact us today to schedule an appointment and begin the journey of living pain-free!