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A facet medial branch block is a diagnostic procedure typically used to determine whether you are a candidate for a radiofrequency ablation. The medial branch nerves feed out from the spine’s facet joints and are responsible for carrying pain signals to the brain. A radiofrequency ablation creates heat lesions that destroy targeted medial branch nerves, blocking the pain signals. Before destroying the nerves, though, we need to be certain that they are responsible for your pain. Here is what you should know about a facet medial branch block.
A facet medial branch block is a simple procedure in which a powerful anesthetic is injected into the targeted nerves. Several areas may be injected at the same time. IV sedation is available, although it is not required. Please note that if you choose sedation, you will need to bring someone with you to drive you home.
You will lie face down on a procedure table. After cleaning your skin with an antiseptic, we will administer a local anesthetic that may sting for a few moments. We will then use fluoroscopy (X-rays) to guide a small, thin needle to the target area. We will inject a bit of contrast dye to confirm the needle placement and then slowly inject an anesthetic into each specific nerve. The entire procedure takes 15 to 30 minutes.
You will then move to a recovery room for 20 to 30 minutes. We will ask you to perform some movements that normally induce pain to see if the nerve block has reduced the pain.
You will then be free to leave with instructions to carry on with your normal activities and keep a pain diary over the next several hours. Do not drive if you have had sedation; avoid pushing yourself to do too much too fast, but gently try to perform activities and movements that typically cause pain. Recording your pain levels at these times will help us determine whether the nerve block was successful.
You may continue your regular medications on the day of the procedure, except that we ask you not to take any pain medicine for the first 4 to 6 hours to avoid interfering with the diagnostic feedback. You may feel a slight numbness or weakness in the injected area. This is normal and should subside within a few hours.
After the Procedure
A facet medial branch block is a diagnostic tool rather than a treatment. The anesthetic will wear off in 4 to 6 hours, and your regular pain levels will return. You may also feel some discomfort at the injection site for a couple of days, which can be relieved by applying a cold pack to the area.
We will schedule a follow-up to go over your results and discuss your candidacy for a radiofrequency ablation. If your nerve block provided significant pain relief (typically 80% relief or more), radiofrequency ablation may be the appropriate next step.
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If you are ready for a new, fully integrated approach to health and wellness, contact CORE Medical & Wellness today at 888-521-0688 to learn more or schedule your appointment!
Dr. Richard Kang is double board certified in anesthesiology and pain medicine, and he completed an interventional pain medicine fellowship at the prestigious New York Presbyterian Hospital / Columbia University – College of Physicians and Surgeons. Read his full bio here.