Lumbar Medial Branch Blocks

Where does low back pain come from?

That approximately 80 percent of all Americans suffer from back pain at some point in their lives? In fact, back pain is the second most common reason for visiting a doctor and the third most common reason for undergoing surgery in the United States. Lumbar medial branch blocks make it possible to better diagnose the source of chronic lower back pain and treat them as least invasively as possible.

What are lumbar facet injections?

Lumber medial branch blocks are diagnostic injections indicated for patients who suffer from chronic low back and buttock pain that is believed to be caused by inflammation in the facet joints on the back of the spine. When these facet joints become inflamed, the nearby medial branch nerves send pain signals that present as achiness and pain that may radiate to the back and buttocks. During this procedure, an injection containing an anesthetic is applied to the medial branch nerves located near the facet joints in the lumbar spine. Anesthetic applied to the affected area can provide significant short pain relief, restoring joint mobility and quality of life. More importantly, they provide diagnostic information to identify the sources of your pain. If our patients experience significant short-term relief following a medial branch block, they may be candidates for a radiofrequency ablation procedure which may provide more significant long-term relief. 

pain treatments

What is a lumbar facet medial branch block?

This is an injection of numbing medicine. It bathes the medial branch nerves, which attach to the facet joints of your spine. These nerves hurt when facet joints are injured or diseased. The injection helps find the source of your pain. And it may relieve your pain for a brief time.

The goal of medial branch blocks are to determine whether or not you would be a good candidate for a radiofrequency ablation procedure. Typically, two sets of injections are required prior to the ablation procedure.

If you have over 80% or greater relief for a short period of time after a medial branch block, you are likely a great candidate for a radiofrequency ablation. 

What is a lumbar facet radiofrequency ablation?

A radiofrequency ablation procedure is much like a medial branch block procedure. However, it involves the use of a special type of needle that allows the physician to make small, focal lesions to disrupt the small medial branch nerves from transmitting the pain, providing you with long-term relief of your symptoms. It is typically performed after you have reported significant short-term pain relief following two diagnostic medial branch block procedures which will help ensure that you’d benefit from a radiofrequency ablation procedure.

Relief from radiofrequency ablations typically lasts between 6-15 months. 

Frequently Asked Questions

If you have chronic pain that seems to radiate across the low back or buttocks, perhaps worsening when you move lean backwards or side-to-side, you may be a candidate for lumbar medial branch blocks. Medial branch blocks are used as diagnostic tools to determine whether the pain is the result of facet joint inflammation. The results obtained after an initial injection are usually an indication of whether additional medial branch blocks or radiofrequency nerve ablation could be beneficial.

Lumbar medial branch blocks are outpatient procedures that usually take less than 30 minutes to complete from start to finish. The procedure involves several small injections with the use of x-ray guidance and local anesthetic at the treatment site. Once the needles are in place, a small amount of anesthetic is injected near the anatomical location of each medial branch nerve being targeted.

You’ll be kept at your doctor’s office for observation for a short period of time after your injection is completed. After you leave the office, we typically encourage you to go about your usual daily activities to see if the procedure provided you with significant relief of your pain. We will give you an hourly pain diary to track your experience and discuss the results a few days after your procedure. It’s normal to only experience short term relief of your symptoms given that the anesthetic typically wears off after several hours. However, if your pain significantly improves immediately after the procedure, you may respond well to a radiofrequency ablation procedure which may provide significant long term pain relief.


 Call our office at 615-988-8100 to schedule your appointment today.