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Lumbar Medial Branch Blocks

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Description

A lumbar medial branch block is a diagnostic injection used to determine if your back pain is originating from small nerves that act as pain receptors to the joints in your back (called facet joints). Since more than one of these joints may be contributing to pain, usually multiple joints are injected at one time, so it is less likely that the painful joint(s) are missed. Only your right side or left can be injected at one time.

How it is performed

You will be lying on your stomach for the procedure. After the skin along the injection site is well cleansed, up to 4 needles will be placed into your low back. The injection is performed under x-ray guidance to confirm that the needle has reached the appropriate area in your back. The injection contains an anesthetic (numbing agent) which temporarily numbs the small nerves. Contrast medication is often used during x-ray to ensure the medication is reaching the appropriate spot.

The potential benefits

It is important to understand that the goal of this injection is to provide temporary relief of your left or right-sided low back pain. If you experience pain relief following the injection, it usually lasts for several hours and will be worn off by the next day. The injection is a test procedure to see if you are a candidate for further treatment. If you have significant temporary relief following the injection, then usually a second injection is performed to the same joints on a different date in order to confirm the diagnosis. If significant temporary pain relief occurs following both of these injections, then you may be a candidate for a treatment called radiofrequency neurotomy, which is a procedure that deadens those nerves and can provide much longer pain relief.

The potential risks

Fortunately, the risks of the injection are much lower than the risks of surgery. If side effects occur, they usually resolve on their own within a few days. The most common side effects are temporary soreness at the injection site and a temporary numb sensation along the back. Potential complications can include, but are not limited to, problematic bleeding, nerve damage, or infection. However, these complications rarely occur.

What to expect after the procedure

After the injection is completed, you will wait in the recovery room for at least 10 minutes if you did not receive IV sedation for the procedure, or at least 30 minutes if you received IV sedation. When preparing to leave from the facility, you will be given a written sheet containing more detailed discharge instructions. You should make a follow up appointment 1-2 days after the injection, to discuss the results of the injection and to develop a corresponding treatment plan.

Please contact our office at 630-372-1100 if you have any additional questions or concerns.

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