Medial Branch Block – Spinal Injections
Also known as: facet joint block
A medial branch block is a diagnostic and therapeutic spinal injection used to target specific nerves that transmit pain from the facet joints, helping to identify the source of pain and potentially providing relief. There are a number of different types of injections available.
What is a medial branch block?
A medial branch block is a specialised type of spinal injection designed to diagnose and treat pain originating from the facet joints. These small joints, located between each vertebra in the spine, play a crucial role in providing stability and facilitating movement. When these joints become inflamed or injured, they can cause significant pain. The medial branch nerves are responsible for transmitting these pain signals to the brain. By injecting a local anaesthetic and/or steroid medication into these nerves, a medial branch block can effectively block the transmission of pain signals and reduce inflammation, providing relief from discomfort.
Types of spinal injections
Spinal injections are a minimally invasive treatment option used to manage various types of back pain by targeting specific areas of the spine. These injections can help relieve pain, reduce inflammation, and aid in diagnosing underlying conditions. Some of the most common types include:
- Epidural Steroid Injections: These injections deliver anti-inflammatory medication into the epidural space surrounding the spinal cord and nerve roots. They are effective in treating conditions like herniated discs, spinal stenosis, and radiculopathy, providing pain relief for both back and leg pain. An epidural injection is particularly useful for pain that originates from the spine and affects the limbs.
- Facet Joint Injections: Aimed at the facet joints in the spine, these injections use a combination of local anaesthetic and steroid medication to reduce inflammation and pain, particularly in cases of arthritis or facet joint disorders. A facet joint injection is a treatment method for pain relief in the facet joints between vertebrae, especially for diagnosed pain conditions linked to arthritis or injury.
- Medial Branch Block Injections: This diagnostic procedure involves injecting a local anaesthetic near the medial branch nerves that transmit pain signals from the facet joints. If pain relief is achieved, it confirms that the facet joints are the source of the pain.
- Sacroiliac Joint Injections: Targeting the sacroiliac joints, which connect the pelvis to the lower spine, these injections use a mix of local anaesthetic and steroids to reduce inflammation and alleviate lower back pain.
Each type of injection serves a unique purpose, offering targeted treatment options for various spine-related conditions.
Why you might need a medial branch block injection
Spinal injections can provide significant pain relief and improve function for patients with various types of back pain. Here are some of the key benefits:
- Quick and effective pain relief: Spinal injections can provide rapid pain relief, often within a few days of the procedure. This can be particularly beneficial for patients experiencing severe pain that interferes with daily activities.
- Minimally invasive: Spinal injections are a minimally invasive procedure, which means they do not require surgery or a long recovery time. Patients can often return to their normal activities shortly after the procedure.
- Targeted treatment: Spinal injections allow for targeted treatment of the affected area, which can help to reduce pain and inflammation more effectively than systemic medications.
Who performs spinal injections
Spinal injections are typically performed by healthcare professionals with specialised training and expertise in pain management. Some of the healthcare professionals who may perform spinal injections include:
- Pain management specialists: These doctors specialise in the diagnosis and treatment of chronic pain. They have extensive experience in performing spinal injections and other pain management procedures.
- Anaesthesiologists: These doctors specialise in the administration of anaesthesia and pain management. They are skilled in performing spinal injections to help manage pain.
- Physiatrists: These doctors specialise in physical medicine and rehabilitation. They focus on restoring function and reducing pain through various treatments, including spinal injections.
- Radiologists: These doctors specialise in the use of imaging technologies, such as X-rays and MRI scans, to diagnose and treat medical conditions. They often assist in guiding the needle during spinal injections to ensure accurate placement.
- Spine surgeons: These doctors specialise in the surgical treatment of spinal conditions. While they primarily perform surgeries, they may also perform spinal injections as part of a comprehensive treatment plan.
It’s essential to choose a qualified and experienced healthcare professional to perform your spinal injection. They will be able to assess your condition, determine the best course of treatment, and perform the procedure safely and effectively.
Hospital fee guide price: £1,820
Procedure price subject to bespoke quotation
*Additional consultant fee not included
Before treatment
Spinal injections are performed on an outpatient basis, meaning you can be treated and go home the same day. There are generally no special preparations required for the procedure. You can eat and drink as usual and continue taking most medications.
However, if you are taking blood-thinning medications such as Warfarin, Clopidogrel, Rivaroxaban, Dipyridamole, or Dabigatran, please inform us before your appointment.
During treatment
When you arrive, you will be directed to our imaging department, as spinal injections are performed using real-time X-ray guidance. We will ask you some questions and monitor your vital signs. After you sign a consent form agreeing to the procedure, you will be escorted to the treatment room and asked to lie face down on a bed.
The doctor will clean the skin in the area of the injection site, preparing it for the local anaesthetic. Once the area is numbed, the doctor will guide a needle into the targeted area of your back using real-time X-ray guidance.
Once the needle is positioned correctly, the doctor will inject the medication, which may include an epidural steroid injection to reduce inflammation and alleviate pain.
The entire procedure typically takes between 15 and 30 minutes.
After treatment
After the procedure, you may experience temporary numbness, weakness, or tingling in your legs, but these sensations should subside within a few minutes. You will be taken to a recovery room where you can rest and have something to eat. Our nurses will monitor your blood pressure during this time. Once you are stable, you will be cleared to leave, but you will need someone to take you home, as you won’t be able to drive. Epidural injections can also play a crucial role in diagnosing the source of pain and managing recovery.
Once at home, it’s important to take it easy and rest. You should be able to return to work the following day.
Your consultant will provide specific post-procedure instructions, which may include keeping a pain diary. It can take up to 6 weeks for full pain relief, so it’s important to be patient and follow all guidance to ensure a smooth recovery.
Risks of spinal injections
Like any medical procedure, spinal injections also carry some risks and potential side effects. These include:
- Infection: As with any invasive procedure, there is a risk of infection with spinal injections. Proper sterile techniques are used to minimise this risk.
- Bleeding: There is a risk of bleeding or hematoma at the injection site, especially in patients taking blood-thinning medications.
- Nerve damage: There is a risk of nerve damage or injury during the procedure, although this is rare when performed by an experienced professional.
- Allergic reaction: Some patients may be allergic to the medication used in the injection, which can cause an allergic reaction. It is important to inform your doctor of any known allergies before the procedure.
Appointment and Treatment Plan
Appointment
Based on your previous consultation with a doctor, an appointment will be arranged between you and your surgeon.
Treatment plan
During this appointment, you’ll go through your medical history, the surgery, the recovery, and together, you’ll decide whether this is a viable option for you.
Pre-op assessment
If the procedure is an option, then the surgeon and their team will thoroughly assess whether you’re right for the procedure. They’ll consider your current health, any previous issues, and other external matters.
Procedure
Prior to going through the procedure, our team will ensure that you’re prepped once again. If everything is confirmed, you’ll undergo the procedure and then we’ll explain the aftercare instructions.
Aftercare
If necessary, you’ll stay in a ward for a few hours to ensure that you’re ready to go home after the surgery. However, this may depend on the surgery outcome and whether you need moderate or light assistance.
Follow-Up
You’ll come in a few weeks later and we’ll give you one final check-over to ensure that you’re on track for recovery.
Experts
We are proud to provide patients with access to a wide range of clinicians, chosen specifically for their knowledge and reputation in their area of expertise. Our experts align with our values: putting you at the centre of your care and educating you on your options at each step of the journey. We encourage you to learn more about our clinicians and how they can help you below. As always, please contact our patient services team if you require any additional information.
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Hospital fee guide price: £1,820
Procedure price subject to bespoke quotation
*Additional consultant fee not included
FAQs
Epidural steroid injections (ESIs) are a common and effective treatment for pain caused by inflammation and irritation of the spinal nerve roots. This type of spinal injection involves administering a steroid medication directly into the epidural space, which surrounds the spinal cord and nerve roots. The steroid medication works to reduce inflammation and swelling in this area, which can lead to significant pain relief and improved mobility. ESIs are particularly beneficial for conditions such as herniated discs, spinal stenosis, and radiculopathy, offering a non-surgical option for managing back and leg pain.
A medial branch block works by targeting the medial branch nerves that carry pain signals from the facet joints to the brain. During the procedure, a local anaesthetic and/or steroid medication is injected into these nerves. This injection helps to reduce inflammation and swelling, which can provide significant pain relief. Additionally, the procedure serves a diagnostic purpose. If the patient experiences pain relief following the injection, it confirms that the facet joints are the source of the pain. Depending on the results, the block can be repeated as needed, or a more permanent solution, such as radiofrequency ablation, may be considered to provide longer-lasting relief.