Treatment guide
Medial Branch Blocks
Diagnostic injections used to assess whether spinal facet joints are contributing to pain.
Overview
Medial branch blocks are diagnostic procedures. Each facet joint is supplied by a small nerve called a medial branch, which carries pain signals from the joint to the spinal cord. By placing a small amount of local anesthetic next to the selected medial branch nerves, those signals can be temporarily switched off.
What happens next is the diagnostic information: if your typical pain decreases substantially for the duration of the anesthetic, that is strong evidence the facet joints supplied by those nerves are a genuine pain source. If the pain does not change, that is equally informative, because it redirects the evaluation toward other structures.
Conditions treated
Considered when history and examination suggest facet-mediated pain: persistent neck or back pain that is worse with extension or rotation, localized beside the spine, and not explained by nerve root symptoms or other identified sources.
Who may be a candidate
Appropriate when a focused evaluation has raised the question of facet joint involvement, often after conservative care has not provided adequate relief, and when confirming or ruling out the facet joints would meaningfully change the treatment plan. Because these are diagnostic procedures, they are used when a precise answer about the pain source is the next needed step.
What to expect
You will be positioned on the procedure table, the skin will be cleansed and numbed, and a thin needle is guided to each target with fluoroscopic (X-ray) imaging. A small volume of local anesthetic is placed beside each selected nerve. The procedure typically takes 15 to 30 minutes, followed by brief monitoring.
Recovery
You can usually go home shortly afterward and resume normal activities the same day, with a companion if sedation is used. The injection site may be sore briefly. The most important part of recovery is the pain diary: you will be asked to track how your typical pain behaves over the hours the anesthetic is active, because that record is what the diagnostic result depends on.
Potential benefits
The primary benefit is diagnostic clarity. A well-performed block, with a carefully tracked response, either confirms the facet joints as a pain source or moves the evaluation elsewhere. That answer protects you from treatments aimed at the wrong structure and is the standard gateway to considering radiofrequency ablation.
Risks and considerations
Bleeding, infection, and allergic reaction are possible but uncommon. Temporary numbness or mild weakness can occur if anesthetic spreads near other nerves, and it resolves as the anesthetic wears off. Some people feel light-headed or sore. An unclear or negative result is itself a possible outcome, which is why responses are interpreted carefully rather than assumed.
Common questions
Frequently asked questions
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Start with a conversation about your symptoms and goals.
This information is educational and does not replace an individual medical evaluation. If you have a medical emergency, call 911.