Medial Branch Block

A Medial Branch Block (MBB) is a minimally invasive diagnostic procedure used to identify whether the facet joints of the spine are the source of your pain. During this quick outpatient procedure, a small amount of anesthetic is injected near the medial branch nerves that supply the facet joints. If your pain is significantly reduced afterward, it confirms that these joints—and their nerve supply—are contributing to your symptoms. For many patients, MBBs provide both diagnostic insight and temporary relief, helping guide future treatment options such as radiofrequency neurotomy.

Quick facts

  • Setting: Outpatient, image-guided
  • Time: ~20–30 minutes
  • Anesthesia: Local with optional light sedation
  • Recovery: Same-day discharge; resume light activities within 24 hours
  • Purpose: Diagnostic; identifies facet joint–related pain

Who it helps

  • Chronic neck or low back pain from arthritis or degeneration
  • Facet joint syndrome
  • Pain that worsens when bending backward or twisting
  • Persistent spinal pain not relieved by medication or therapy
  • Patients being evaluated for radiofrequency neurotomy

How it works

Each facet joint in the spine is connected to tiny medial branch nerves that transmit pain signals. During a medial branch block, your provider uses fluoroscopic (X-ray) guidance to place a fine needle near these nerves and injects a small amount of numbing medication. If your pain improves significantly after the injection, it suggests that the facet joints are the pain source. This information helps confirm whether radiofrequency neurotomy—a longer-lasting treatment—is appropriate.

What to expect

  • Before: Your provider will review your medical history and imaging. You may be advised to stop blood thinners before the procedure.
  • During: You’ll lie comfortably on your stomach or side. After numbing the skin, your provider uses X-ray guidance to position a thin needle near the medial branch nerves and inject a small amount of anesthetic.
  • After: You’ll rest briefly in recovery before going home. Temporary numbness or relief of your usual pain for several hours is expected. You’ll track your pain level for the next day or two to assess the response.

Benefits & risks

Benefits:

  • Identifies whether facet joints are causing pain
  • Provides temporary relief of neck or back pain
  • Helps determine eligibility for radiofrequency neurotomy
  • Quick, outpatient procedure with minimal recovery time

Risks:

  • Temporary soreness or bruising
  • Infection or bleeding (rare)
  • Allergic reaction to medication (rare)
  • Temporary numbness or lightheadedness

Is it right for me? (Checklist)

  • ✅ Chronic neck or low back pain related to facet joint arthritis
  • ✅ Pain worsens with movement or prolonged posture
  • ✅ Relief after prior facet or diagnostic injections
  • ✅ Considering longer-lasting treatment such as radiofrequency neurotomy

Alternatives at PCET

FAQs

  • Is this a treatment or a test? Medial branch blocks are primarily diagnostic, helping identify the pain source.
  • How long does relief last? Relief typically lasts several hours to a few days, depending on the medication used.
  • What if I feel significant relief? A strong response confirms the facet joints as the pain source, and you may be a candidate for radiofrequency neurotomy.
  • Will it hurt? Most patients feel only mild pressure; local anesthesia minimizes discomfort.
  • Is it covered by insurance? Most insurance plans, including Medicare, cover MBBs when medically indicated.

📞 Call to Schedule

If you’re struggling with chronic neck or back pain and want clear answers about its source, a Medial Branch Block may help. Call us at 865-934-2567 to schedule your appointment today.