MEDIAL BRANCH NERVE BLOCK: What to expect

> Will I be “put out” for this procedure?
Not usually. This procedure is normally performed under local anesthesia. Some patients also receive intravenous sedation and analgesia, which makes the procedure easier to tolerate. The amount of sedation given generally depends upon the patient’s tolerance. If you think you will require a general anesthetic for this procedure, please inform us at least 1 week in advance of your appointment. Dr. Becker will arrange for another Board Certified Anesthesiologist to be there for you for the anesthetic portion of your procedure.

> How is the injection performed?
It is done either with the patient lying on the stomach for the upper and low back pain, or for the cervical (neck area) injections – lying on your side or lying on the back, under x-ray control. The patients are monitored with EKG, blood pressure cuff and blood oxygen-monitoring device. The skin in the back is cleaned with antiseptic solution and then the injection is carried out. Sterile procedures are used throughout the injection.

> What should I expect after the injection?
Immediately after the injection, you may feel that your pain may be gone or quite less. This is due to the local anesthetic injected. This may last only for a few hours. Your pain will return and you may have a “sore back or neck” for a day or two. This is due to the mechanical process of needle insertion. It is very important for you to keep a track of your pain and stiffness for the next 2 to 12 hours following injections. Your response to the injections will determine if the facets are the cause of your pain or not.

> What should I do after the procedure?
You must have a ride home. We advise the patients to take it easy for a day or so after the procedure. You may want to apply ice to the affected area. Perform your usual activities as tolerated.

> Can I go to work to work the next day?
Unless there are complications, you should be able to return to your work the next day. The most common thing you may feel is slight soreness at the injection sites.

> How long does the effect of the medication last?
The immediate effect is from the local anesthetic injected. Depending upon the medication injected, it can last from 2 hours to 8 hours. Of course, if the facet joints are not the source of your pain, you may not have much relief, but this is important for us to know.

> How many injections do I need to have?
Usually one session is enough to determine if the facet joints are the most likely source of your pain or not. However, the “placebo response” can be as high as 30 to 40 % and some patients may be recommended to have repeat diagnostic injections. In addition, “False Positive” responses can occur.