Medial Branch Block (Lumbar)

painful facet joint
contrast solution

This diagnostic procedure is performed to identify a
painful facet joint. The facet joints are the joints
between the vertebrae in the spine. They allow the
spine to bend, flex and twist.

In preparation for the procedure, the patient is
positioned on his stomach. The physician injects a
local anesthetic. This numbs the skin and tissue
around the facet joint that is suspected of causing
the patient's pain.

Contrast Dye Injected
Once this tissue is numb, the physician inserts a
needle into the skin. The needle is carefully guided
down to the facet joint. The physician injects a
contrast solution through this needle. The contrast
solution helps the physician see the area on a
camera called a fluoroscope. The fluoroscope
provides live x-ray images. The physician uses the
fluoroscope to confirm the location of the needle's

Anesthetic Injected
Once the physician has confirmed that the needle is
positioned correctly, the physician attaches a
syringe containing an anesthetic medication. This
medication is injected around small nerves called
the medial branch nerves. These carry signals to
and from the facet joints. The anesthetic will
temporarily block sensation in these nerves.

End of Procedure
If the temporary injection relieves the patient's pain,
the physician may inject a more long-lasting
anesthetic. If the temporary injection does not
relieve the pain, the physician may test nearby
facet joints to identify the correct one. Once the correct pain location has been identified, the long term treatment would be to proceed with radiofrequency ablation of the medial branches of the level(s). 

Watch the video description below

Lumbar Medial Branch Blocks by Dr. Ghalambor