10 Things to Know About a Medial Branch Block and What Comes After

A medial branch block is a minimally invasive procedure that can provide relief for individuals suffering from chronic back pain. It involves the injection of a local anesthetic near the medial branch nerves, which are responsible for transmitting pain signals from the spinal joints to the brain. This guest post will outline seven important things to know about a medial branch block and what comes after the procedure.

1. Diagnosis and Preparations

Before undergoing a medial branch block, proper diagnosis is crucial. Most commonly, this procedure is recommended for individuals who have been diagnosed with facet joint pain or arthritis in the spine. Before the treatment, the patient’s medical history, physical examination, and imaging tests play a significant role in ensuring accurate diagnosis.

2. The Procedure Itself

A typical medial branch block procedure usually takes around 30 minutes to complete. Firstly, a local anesthetic is applied to numb the area where the injections will be administered. Once ready, a thin needle is inserted near the targeted medial branch nerves with guidance from X-ray imaging called fluoroscopy. A solution containing both an anesthetic and anti-inflammatory medication is then injected near these nerves. Wondering what is the next step after a medial branch block? Read on.

3. Immediate Post-Procedure Recovery

Following a medial branch block, patients are generally kept under observation for a short period in order to monitor any potential complications or adverse reactions to the medication administered. After this brief recovery period at the healthcare facility or clinic, patients are typically able to resume their normal daily activities without significant downtime.

4. Expectations and Results

While every individual’s experience may vary, many patients will begin to notice pain relief within just a few hours after undergoing a successful medial branch block procedure. This temporary relief serves as a confirmation of accurate nerve targeting as well as an initial indication that radiofrequency ablation (RFA) may be suitable for long-term pain management.

5. Radiofrequency Ablation – The Next Step

If substantial short-term pain relief is experienced following a medial branch block, the next recommended course of action is often radiofrequency ablation (RFA). RFA is a minimally invasive procedure that uses heat generated by high-frequency electrical currents to disable the targeted medial branches, providing longer-lasting pain relief.

6. Repeating the Procedure

Medial branch blocks are generally intended as a diagnostic tool rather than a long-term treatment option. Typically, for individuals who experience pain relief from RFA after their initial medial branch block, subsequent blocks may not be necessary unless there is a return of symptoms. However, for those who do not respond well to the procedure, additional medial branch blocks may be used as an alternative or in conjunction with other forms of pain management.

7. Limits and Potential Risks

Although medial branch block procedures are considered safe and minimally invasive with relatively rare complications, it is essential to consider the risks involved. Some potential side effects may include infection at the injection site, bleeding, nerve damage, or an allergic reaction to medication. It is important for patients to discuss any concerns they may have regarding these risks with their healthcare provider prior to the procedure.

8. Managing Discomfort after the Procedure

It is common for patients to experience mild discomfort or soreness in the injection area following a medial branch block. This can usually be managed with over-the-counter pain medications and rest. Applying ice packs or using heating pads may also help alleviate any discomfort. However, if the pain becomes severe or if there are signs of infection, it is important to consult with a healthcare professional.

9. Follow-up Care and Consultations

After undergoing a medial branch block, it is essential to schedule follow-up appointments with the healthcare provider who performed the procedure. These appointments allow for proper evaluation of the effectiveness of the treatment and enable adjustments in the management plan if necessary. Patients should communicate any changes in their symptoms, both improvement or recurrence, during these follow-up consultations.

10. Lifestyle Modifications and Physical Therapy

While medial branch blocks can provide temporary pain relief, it is crucial to adopt healthy lifestyle habits and engage in physical therapy exercises that will support long-term pain management efforts. Maintaining a healthy weight, practicing good posture, incorporating regular exercise into daily routines, and learning proper body mechanics can all significantly contribute to managing chronic back pain associated with spinal facet joint issues.


Understanding the ins and outs of a medial branch block can help individuals make informed decisions about their chronic back pain management. Although it serves as both a diagnostic tool and temporary relief for pain associated with spinal facet joint issues, further treatment options, such as radiofrequency ablation, may provide more viable long-term solutions. By discussing all available options with medical professionals, patients can take steps toward finding effective long-term pain management strategies that suit their specific needs.

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