Medial Branch Blocks

What are Medial Branch Blocks?

A doctor may recommend a medial branch block and/or a medial branch radiofrequency neurotomy (ablation) as part of a patient’s health care plan.

A medial branch nerve block is a procedure in which an anesthetic is injected near small medial nerves connected to a specific facet joint. Typically several levels of the spine are injected in one procedure.

What is a Medial Branch Nerve?


Bones called vertebrae make up your spine. Each vertebra has facets (flat surfaces) that touch where the vertebrae fit together. These form a structure called a facet joint on each side of the vertebrae. The Medial Branch nerve passes through the facet joints.

The Procedure

  • The skin at the site of treatment is first cleaned and then numbed with medication.
  • Live x-ray imaging is then used to help the doctor locate the spine and guide the treatment. An x-ray dye is then injected into the treatment area to help achieve a better image.
  • A powerful anesthetic is then injected into the joint, and this procedure is repeated with each injured joint.

How Long does the Procedure Take?

Medial branch blocks are performed on an outpatient basis. The procedure typically requires 30 minutes, including preparation time. It is followed by 30 minutes of observed recovery time.

How Often Should this Procedure be Done?

Medial branch blocks in one area are generally limited to three within a six-month time frame. In many instances, only one or two injections are required to obtain benefit.

After the Procedure?

Most often, you can go home about 10-15 minutes after the procedure. The anesthetic wears off in 1-2 days. When it does, your back or neck may feel more sore than usual. This is normal. The medial branch block has to be done twice, usually 2-4 weeks apart. If relief is experienced both times, the next step will be a Radiofrequency Lesioning also called an Ablation of the medial branch nerve.

What are the Expected Results?

Medial branch blocks have been performed safely for many years with excellent outcomes. The benefit from this procedure will typically occur several minutes following the procedure. The patient is asked to record pain levels during the first days of the procedure to ensure accurate diagnosis of the facet joints as the pain source.

Is everyone a candidate for medial branch blocks?

Medial branch blocks can help many people suffering from back pain. On rare occasions, patients can be allergic to the injected medications. Patients on blood-thinning medication or patients with an active infection should avoid medial branch blocks. Certain medications should be stopped a few days before the surgery. To learn more about whether a medial branch block is the right treatment option, speak with a pain management specialist.