Medial branch blocks may be another alternate to epidural steroid injections. Epidural steroid injections are not always helpful for the treatment of low back pain. Patients may describe transient or minimal relief with a block or block series. Many times epidurals do not improve back pain because they do not target the true source of a patient’s pain, such as inflammation or degeneration within the facet joints of the spine. This condition is called Facet Disease, Facet Syndrome, or lumbar spondylosis. Patients will typically complain of pain at or above their waist that does not radiate into their legs (or that radiates above the knee). Facet Disease can often be seen on imaging such as MRI, CT scans, or X-rays and can also be suspected after a physical exam done by your provider. However, the diagnosis of facet disease is confirmed by facet blocks or medial branch blocks.
Medial Branch Blocks
Medial branch blocks are a series of three procedures administered to diagnose and treat Facet Disease. The first two procedures involve injections using a medication, such as lidocaine, to numb the nerve that supplies the painful joint. Relief is usually short lived, but if pain is diminished this is a diagnostic indicator of Facet Disease. The third procedure in the series is called a radio frequency ablation, or medial branch radio frequency ablation. With this procedure, instead of only numbing the nerves to provide temporary relief, we will heat them so the nerve cannot properly signal to the brain that there is pain. This should provide more long-term pain relief and patients can expect results to last anywhere from 6 months to a year.
Talk with your provider to see if medial branch blocks could be beneficial in treating your lower back pain.
At Cahaba Pain our team of providers are highly trained regarding this procedure and would love to discuss the benefits of this treatment with you.
For more details on this procedure, please click here.
Natalie Chism, CRNP & T. Wade Martin, MD