Medial Branch Blocks Back Pain

Low back pain and neck pain can be debilitating and can substantially decrease quality of life. For those who are suffering from chronic pain due to an injury or trauma, or those who are experiencing pain exacerbated by age and lifestyle, Medial Branch Blocks for Back Pain could provide needed relief. The team at Texas Pain Care in Sugar Land, Missouri City, and Houston is here to help.


A medial branch block is a minimally-invasive and non-surgical treatment for patients who experience chronic low back and neck pain by targeting damaged or inflamed facet joints in the spine. But how do the blocks work, and what are they blocking? 

It’s helpful to first understand the anatomy of the spine to best understand how medial branch blocks work. The spine itself consists of vertebrae that are cushioned by intervertebral discs that are further supported by facet joints. These joints help control the movement of the spine and provide extra support and stability for the vertebrae, helping the body to safely flex and twist. The medial nerves are small branch nerves near these facet joints in the spine that carry pain signals from the joints to the brain. The combination of time and use can cause the joints to become inflamed and irritated, which creates these pain signals. A medial branch block stops these pain signals via an injection of anesthetic and/or steroid near the medial branch nerves, reducing inflammation and irritation in the facet joints of the spine. A medial branch block is much more specific than a steroid injection and the effects generally last longer.

While generally successful, if medial branch blocks don’t provide the intended pain relief, they, at the very least, can be used as a diagnostic tool for more in-depth treatment options. 


The main benefit of medial branch blocks – other than pain relief! – is that if the block reduces pain, that means that the pain originates from the joints and this is the most effective pain treatment. If not, it is still useful as both a minimally-invasive diagnostic tool and as a treatment for lessening pain enough that the patient can take advantage of physical therapy and hopefully normal daily activities. 

Specific medical conditions that medial branch block can help include osteoarthritis, rheumatoid arthritis, facet joint pain and sacroiliac joint pain. While sciatica (sciatic pain) isn’t specifically a medical condition, those who experience pain in the buttock region that travels down the hip and leg can also benefit from a medial branch block. 

Medial branch blocks are effective in treating an injury or condition in the cervical region (neck), thoracic region (upper back) and lumbar region (lower back). 

Overall, a medial branch block is considered an effective pain management option that reduces pain by disrupting damaged or injured nerves in the facet joints from transmitting pain signals to the brain. The injection combination of an anesthetic and steroid numbs the affected area, reduces inflammation, and hinders pain signal transmission, creating a pain-free, non-surgical solution. 

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Medial branch block injections are considered a simple outpatient procedure that generally takes 15 minutes or less, all while the patient is awake and aware. The entire treatment consists of a pain management specialist inserting a thin needle near the medial branch nerves of a facet joint to deliver a long-lasting steroid and an anesthetic. The purpose of the steroid is to reduce inflammation and irritation, and the purpose of the anesthetic is to numb the pain. 

After the injection, the provider will ask the patient to perform a series of small movements to determine the amount of pain relief experienced. If the facet joint proves to be the source of the discomfort, partial or total pain relief can be expected within two to six hours after treatment. 

Pain relief can last for up to four months per injection. Most patients experience relief with one injection, but more might be necessary if there are multiple facet-related sources of pain that need to be treated. 

What are the Risks and Side Effects of Medial Branch Block?

The risks and side effects of medial branch blocks are very minimal. The most problematic risk is misplacement on the needle, but this is combated by placing your care in a provider who is both skilled in this treatment option and who uses all the necessary tools, which include X-rays, ultrasound and fluoroscope. The whole point is to get out of pain, not end up with damaged nerves!

After the injection, most patients find that the injection site might be sore, so an ice pack and over-the-counter pain medication help. Other side effects could include bleeding at the injection site and infection at the injection site. 

As with any steroid ingested or injected into the body, there is a potential risk that the material enters the bloodstream. If that happens, side effects include possible weight gain (mostly due to fluid retention), arthritis, increased blood sugar levels, stomach ulcers and temporarily weakened immune system. 

Do Medial Branch Blocks Work?

Yes! Medial branch blocks are effective in two different ways, either as a treatment option or diagnostic tool. If significant pain relief is experienced after the injection(s), then that means the facet joints are the culprit and this treatment method was a great option for providing quick, comfortable and relatively pain-free relief that lasts for several months. This positive response could also mean that the patient might benefit from a more long-term pain management option, such as radiofrequency ablation (RFA) treatments. 

If the treatment does not provide the intended relief, even after a few injections, then it’s clear that the cause of pain is not the facet joints, and other treatment options can be offered.  

Who Performs Medial Branch Blocks?

While a range of medical professionals offer medial branch blocks to treat low back pain and neck pain, it’s important to place your trust in a team with years of experience. The Texas Pain Care team in Sugarland, Houston and Missouri City areas is available to not only properly diagnose and recommend the best pain management treatment option specific to each patients’ needs, but is also highly skilled at performing each procedure to ensure a high success rate. Schedule an appointment today to see if medial branch blocks are right for you. We’re here to help you get out of pain and provide the best and most comfortable treatment possible. 


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