Spinal Pain Management

Median Branch Block

Like a facet block, a median branch block is a procedure used to alleviate pain due to facet arthritis. The main difference is that while a facet block directly anesthetizes the inflamed joint, a median branch block works by anesthetizing the nerve that transmits pain impulses from the facet joint. A median branch block is considered to be more diagnostically accurate than a facet block in diagnosing pain due to facet arthritis.

To perform a median branch block, the doctor places a small needle through the skin and navigates the needle via x-ray guidance to the sight of the median branch nerve. Importantly, each facet joint is served by two nerves. Each nerve must be treated for a successful pain block. Once at the nerve, anesthetic medication is given. If pain is emanating from the facet joint the anesthetic provides immediate pain relief. It must be noted that the median branch block is a diagnostic procedure only. The affects of the procedure will wear off as soon as the anesthetic medication effects wear off, typically a matter of hours. Therefore, the purpose of this injection is purely to determine which patients will be suited for rhizotomy, a procedure that provides more lasting relief. If the patient responds well to the median branch block, they will be good candidates for a rhizotomy.