MEDIAL BRANCH BLOCKS
We have booked you for medial branch blocks so that we can see if the joints in your spine, called facet joints, are causing you some or all of your pain.
This is strictly a diagnostic procedure which is meant to identify a pain generator that can be treated by radiofrequency neurotomy or injection.
If we get a good response from this injection, meaning your pain drops significantly - even for short amount of time, we may book you for a second injection to confirm that we are in the right place.
Coming to your diagnostic block appointment without pain is like taking your car to the mechanic when the engine isn’t rattling. Think of your pain like that rattling in your engine; without it we won’t be able to diagnose the problem and will have to send you home.
To make an accurate diagnosis we need the rattling to be loud enough and ask that you come to your appointment with a pain score of 4+ out of 10, where 0 = no pain and 10 = the worst pain imaginable.
To ensure you have at least a 4/10 pain score, consider limiting the amount of pain medication you are taking or safely engage in activities or movements that increase your pain.
Frequently Asked Questions
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What is a medial branch block? Medial branch nerves are very small nerve branches that carry the pain message from the facet joints and the muscles around the joints. If the nerves are blocked or numbed, they will not be able to transfer the pain sensation from the joints to the brain.
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Where are facet joints? The facet joints are small joints in the back of the spine that form connections between each vertebra. Each facet joint has two nerves.
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What is the purpose of this procedure? This is a diagnostic procedure. This injection is done to confirm the diagnosis of facet joint disease and to find out which facet joints are contributing to your pain.
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How much time does the injection take? Typically about 15-30 minutes.
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What medicine is injected? We inject a local anesthetic (freezing) like lidocaine or marcaine. Xray dye is also used.
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How is the procedure performed? You lay on your stomach. Your skin is cleansed with antiseptic solution, after which the nerve block is performed under X-ray guidance.
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How long does the effect of the medication last? If the facet joints are the source of pain, you should benefit from the injection immediately. Depending upon the medication injected, the effect can last from 1 hour to 6 hours or more.
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What is the next step after having good relief? If you benefit from the procedure, the next step may include a second confirmatory block, radiofrequency (nerve “burning”) or regenerative injections (platelet rich plasma “PRP”).
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What are the risks and side effects? Serious side effects and complications are uncommon. The most common problem after the injection is having pain in the area of injection for a few days. More rare complications may include infection, bleeding and nerve injury.
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Who should not have this injection? If you have any active infection you should not have the procedure. If you are pregnant or if you are actively trying and it is 10 days past the first day of your last menstrual cycle, you should contact the clinic to see if you are able to proceed. Please, warn us of any allergy especially to local anesthetics, x-ray dye and latex.
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Where will I be having this procedure done? This procedure will be done at the CAPRI Clinic, located at Bay #1, 6220 Hwy 2A, Lacombe, AB.
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Do I need a ride home? If you feel it is necessary, on occasion, the freezing can affect the nerves to the legs making you unfit to drive.
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What do I do following the procedure? You will need to fill out and send back a pain diary that will record what happens to your pain and function when your facet joints are frozen.
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What if you think you are having a serious reaction or complication to the procedure? Call the CAPRI Clinic during office hours or go to emergency. After hours, call the CAPRI Clinic emergency contact number 403-550-3447. (Please do not call this number for booking inquiries or other non-emergency questions.)