Cervical, Thoracic and Lumbar Median Branch Block

What are the median branch nerves and why are median branch blocks helpful?

Median branch nerves are the very small nerve branches that communicate pain caused by the facet joints in your spine. These nerves do not control any muscles or sensation in your arms or legs. They are located along a bony groove in your low back and neck and over a bone in your low back.

What will happen to me during the procedure?

An IV will be started so that relaxation medication can be given. You will be placed on the X-ray table and positioned in such a way that your doctor can best visualize the bony areas where the median branch nerves pass, using x-ray guidance. The skin will be scrubbed using two types of sterile scrub (soap). Next, the physician will numb a small area of skin with numbing medicine. This medicine stings for several seconds.

After the numbing medicine has been given time to be effective your doctor will direct a very small needle using x-ray guidance near the specific nerve being tested. A small amount of contrast (dye) is then injected to insure proper needle position. Then, a small mixture of numbing medicine (anesthetic) and anti-inflammatory (cortisone/steroid) will be injected.

What will happen after the procedure?

You will go back to the recovery area where you will be monitored for 30-60 minutes. You will be asked to try to imitate something that would normally bring about your usual pain. You will then record the relief you experience during the next week on a post injection evaluation sheet (diary). This will be given to you when you are discharged home. You will also be given a follow up appointment. You will not be able to drive the day of the procedure. Your arm, chest wall or leg may feel weak or numb for a few hours.

General Pre/Post Instructions

If you are going to have anesthesia you need to be fasting for eight (8) hours prior to the injection. If you have having local anesthesia you should eat a light, but not a full meal within a few hours before your procedure. If you are an insulin dependent diabetic, do not change your normal eating pattern prior to the procedure. Please take your routine medications (i.e. high blood pressure and diabetic mediations). If you are prescribed an anti-inflammatory, you need to stop taking these medications 5 days prior to the date of the procedure.

These medicines can be restarted after the procedure if they are needed. If you are on Coumadin or Heparin (blood thinners) or Glucophage (a diabetic medicine) you must notify this office so the timing of stopping these medications can be explained. You will be at the office at least two (2) hours for your procedure. You will need to bring a driver with you. You may return to your normal activities the day after the procedure, including returning to work.

If you are unable to keep this appointment, please give notice as soon as possible and at least 24 hours in advance. Thank you.