Medial branch blocks
A medial branch block can help us learn whether small joints in your spine may be a pain source. Your pain diary is an important part of the test.
What is being tested?
Facet joints are small joints at the back of the spine. They help the bones move against one another. Small nerves called medial branches carry pain signals from these joints. A block places numbing medicine near these nerves.
If your usual pain eases while the medicine is working, the joints may be part of the problem. The result is one piece of your care plan, not proof that every symptom comes from a joint.
Why might we suggest a block?
Back or neck pain can come from several places. Your symptoms, exam, and past care help us decide whether joint pain is worth testing. Scans can show changes in a joint, but they do not tell the whole story about where pain comes from.
The goal of this visit is short-term information. It is different from a steroid injection meant to calm swelling or a treatment meant to give longer relief.
Before your visit
Tell us about medicines, allergies, and any new illness. Follow the food, drink, ride, and medicine instructions from our office. Do not stop a prescribed medicine unless your care team tells you to. We will explain which usual, safe activities can help you judge the result.
During the block
We clean the skin and make a numbing plan. Image guidance helps us place a small needle near the chosen nerve. A small amount of numbing medicine is then given. The number of sites depends on which joints we are testing.
Tell us if you feel anxious or need a pause. Numbing medicine can help with the needle steps. A brief cooling spray may be used on the skin when suitable. We do not routinely use sedation for this test because it can change how we read your pain response. We will discuss a plan that supports both comfort and a useful result.
Your pain diary matters
After the block, record your pain at the times we give you. Try only the safe activities agreed with your clinician. Note what you can do more easily and how long the change lasts. Do not push through unsafe activity to test the block.
The relief is meant to wear off. Pain returning as the numbing medicine fades does not by itself mean the test failed. Follow your aftercare plan and contact us if you have concerns.
What happens next?
We review the diary with you. A useful result may lead to another test block or a discussion of radiofrequency ablation, called RFA. RFA treats these small joint nerves to reduce pain signals for longer. It is not automatic after a block.
The number of tests depends on your care plan and coverage. If the block does not help enough, we look at other pain sources and choices. Before testing, your clinician will explain the expected benefits, risks, and alternatives.
Common questions
Is this the same as an epidural injection?
No. A medial branch block targets small nerves near spinal joints. An epidural injection places medicine in the space around spinal nerves for a different pain pattern.
How long should relief last?
This is a short test. The time varies with the numbing medicine and your response. Follow the diary times your team gives you rather than expecting a set number of hours.
What if my usual pain is low that day?
Tell the team before the test. The starting pain level can affect what we learn. We will decide with you how to proceed.
Sources behind this guide
Learn more from these professional and manufacturer resources. Your care plan and written instructions are specific to you.