Facet joints are found on either side of the spine. Each of these joints is about the size of a thumbnail. In the lumbar spine there are 5 vertebrae that are connected by facet joints.
Facet joints connect vertebrae to one another along with guiding the spine when moving.
Medial branch nerves are located near facet joints. They communicate pain from facet joints. Therefore these nerves tell the brain when the facet joint has been irritated or hurt.
Injury to a facet joint typically involves damage to cartilage inside the joint and connecting ligaments surrounding the joint.
Pain from an injured lumbar joint may range from mild muscle tension to more severe pain. This pain can radiate into different areas, depending on which facet joint is irritated.
What is a Lumbar Medial Branch Block (MBB)?
This outpatient procedure is used to help with diagnosing lower back, hip and groin pain.
Medial Branch Block Procedure
A thin needle is inserted near the facet joint under fluoroscopy (a type of x-ray). Fluoroscopy is used to position the needle accurately and safely. A small amount of dye is used by the Physician to assess if the needle is in the proper position. This injected dye can cause some discomfort.
With the correct needle position the area will be numbed with an anesthetic medications.
Do I have Lumbar Facet Joint Pain?
If you have pain for greater than 2 months in the lower back, hip, or groin area you may have facet joint pain
Tests such as X-rays or MRIs do not always show if the facet is the reason for your pain. The best way to test if you have this pain is to block the pain signal from the medial branch nerve.
A Lumbar Medial Branch Block disrupts the function of the lumbar medial branch nerve temporarily. The medial branch nerve is then no longer able to transmit pain signals from the affected facet joint to the brain.
How Long Should the Pain Relief Last?
After your Lumbar Medial Branch Block procedure you will be monitored for approximately 15 – 30 minutes. The clinic will give you appropriate directions to follow as well as complete a pain diary. This pain diary is very important as it will guide the Physician treatment plan for you.
Pain relief will last for approximately 4-6 hours, until the anesthetic wears off.
Short term pain relief is considered a positive test. The Physician will then determine the next step in your treatment plan.
Post procedure soreness may be experienced. Typically this soreness is caused by muscle and nerve irritation.
Do not stop any anti-platelet/anti-coagulant medications (eg. Aspirin, Plavix, Coumadin, etc.) unless instructed to do so by a physician.
Please arrive with your pain level 5/10 or greater to ensure that you will be able to notice the effects of the injection. If your pain level is less than 5/10, your injection may be rebooked. You may want to avoid taking pain medications the day of the procedure