Lumbar Medial Branch Block

A Lumbar Medial Branch Block is an outpatient procedure for diagnosing and treating lower back, buttock, hip and groin pain. This information has been provided by your doctor so you can better understand this procedure. Your doctor will make the best recommendation for your specific needs

WHAT ARE LUMBAR FACET JOINTS?

Facet joints connect the vertebrae (the bones of the spine) and help guide the spine during movement. The lumbar region of the spine contains five vertebrae and is located in the lower back. Facet joints are found on both sides of the spine. Each is about the size of a thumbnail. Lumbar facet joints are named for the vertebrae they connect and the side of the spine where they are found. The right L4-5 facet joint, for example, joins the 4th and 5th lumbar vertebrae on the right side. Medial branch nerves, located near facet joints, transmit pain signals from the facet joints to your brain.

WHAT IS LUMBAR FACET JOINT PAIN?

Lumbar facet joint pain is a result of injury, either to the cartilage inside the joint or the connecting ligaments surrounding the joint. Pain from an injured lumbar facet joint may range from muscle tension to more severe pain. Depending on which facet joint is affected, the pain may occur in an area from your lower back down to your buttocks. The diagram shows areas of pain usually associated with lumbar facet injuries.

HOW DO I KNOW IF I HAVE LUMBAR FACET PAIN?

If you have pain in one or more of these areas, and it has lasted longer than two months, you may have lumbar facet pain. Common tests such as x-rays or MRIs may not always show if a facet joint is the reason for your pain.

WHAT IS A LUMBAR MEDIAL BRANCH BLOCK?

During this procedure, a local anesthetic (numbing medicine) is injected near the medial branch nerve, which stops the transmission of pain signals from the facet joint. If your pain is reduced and you are able to move your back normally, then the doctor will know which facet joint has been causing your pain.

WHAT HAPPENS DURING AN INJECTION?

A local anesthetic may be used to numb your skin. The doctor will then insert a thin needle near the medial branch nerve. Fluoroscopy, a type of x-ray, may be used to ensure the safe and proper position of the needle. A dye may also be injected to make sure the needle is in the correct spot. Once your physician is sure the needle is correctly placed, the medicine will be injected.

WHAT HAPPENS AFTER AN INJECTION?

You will be monitored for up to 30 minutes after the injection. Before you leave, the clinic will give you discharge instructions as well as a pain diary. Keeping track of your pain helps the doctor know what the next step will be. You may want to check for pain by moving your back in ways that hurt before the injection, but do not overdo it. You may feel immediate pain relief and numbness in your back for up to six hours after the injection. This means the medication has reached the right spot.

You should be able to return to work the day after the injection, but always check with your doctor.

HOW LONG CAN I EXPECT PAIN RELIEF?

How long you can expect pain relief depends on how many areas are injured, and on the amount of inflammation. If your pain goes away for a short time, but then returns, you may be a candidate for radiofrequency ablation (RFA) to the medial branch nerve. This procedure provides a more permanent disruption of pain signals.

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