MEDIAL
BRANCH BLOCK (MBB)

Why is this procedure done?
MBB is a diagnostic test to evaluate if facet joints are generating your pain. Facet joints are innervated or “supplied” by the medial branch nerves. Medial branch nerves send pain signals to the brain from the facet joints. MBB’s temporarily block or interrupt the pain signals sent from the facet joint. If the MBB gives you a reduction of your pain by 50% or more, this can indicate that you have facet joint pain and may benefit from Radiofrequency Ablation of the medial branch nerves.

How do I prepare for this procedure?
You should not eat for 4 hours before the procedure. You can take any routine medications before the procedure. You will need to bring a driver to take you home. If you have any changes in your medical condition or are feeling sick, you should contact our office to inform our staff. You should stop all blood thinners, such as: Coumadin, Plavix, aspirin and most arthritis medications. You should stop herbal medicines and supplements one week before the procedure.

What happens during this procedure?
For a Medial Branch Block you will lie on the exam table on your stomach. Please stay as still as you can. The skin over the injection sites is cleaned. A local anesthetic numbs the skin. After the numbing medicine has been given time to be effective, the physician directs small needles, using x-ray guidance to the anatomical locations of the medial branch nerves. A contrast “dye” may be injected to confirm placement. Then, numbing medication (anesthetic) is injected to block the nerves.

What are the side effects?
In general MBB is a safe procedure. Possible side effects include but are not limited to allergic reaction, infection, and bleeding. Precautions are taken including precise x-ray guided injections and the use of sterile technique. Please discuss any specific concerns with your physician.

What happens after this procedure?
The actual day of the procedure is the most important to evaluate your response to the MBB. You will be given a pain diary, which indicates both hours and days post-procedure – please fill this form out. Additionally, it is important to move around and do activities that would generally create your pain (this information can be written at the bottom of your pain diary).

You may not drive the day of the injection. You can drive the next day. You may resume all of your medications, but try to limit your pain medications for the first 6 hours after the procedure so that the diagnostic information obtained from the injection is accurate. Call the office for any significant increase in pain, headache, fever, new weakness or numbness, or loss of bowel or bladder control.

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