Who Is the Ideal Candidate for a Medial Branch Nerve Block?

The medial branch nerve block (MBNB) is an alternative treatment utilized by some pain doctors working to relieve chronic back pain. It’s a very specific treatment and one that isn’t appropriate for every back pain issue. More often than not, it is used to treat issues relating to facet joints.

On their website, Lone Star Pain Medicine makes note of the fact that MBNB is not normally utilized as a permanent fix. Rather, doctors rely on it to help them confirm the source of a person’s pain. If the issue truly is with one or two facet joints, there are other treatments doctors can look at. If the issue is not facet-related, MBNB will not help anyway.

A Rundown of the Procedure

Patients to whom the therapy has been recommended can take comfort in the fact that it’s minimally invasive and fairly easy. It involves little more than an injection of anesthetic to relieve pain.

The patient lies face-down on an exam table. Local anesthetic is applied to numb the skin. Then, using fluoroscopy, the doctor guides a needle to the suspected site of injury or disease. Anesthesia is injected to immediately numb the surrounding nerves.

If the treatment is successful, the doctor’s diagnosis of a facet issue is correct. Yet a lack of pain relief indicates that the targeted facet joint is not problematic. The doctor then needs to look at other possibilities.

Criteria for Eligibility

With the basics out of the way, we can look at the ideal candidates for MBNB. Pain doctors typically look for certain characteristics as follows:

• Chronic Pain – Doctors look for chronic neck or lower back pain that has lasted for at least six months.
• Lack of Response – The patient has undergone more traditional treatments but failed to respond. Those treatments could include physical therapy, chiropractic, and anti-inflammatory meds.
• Facet Symptoms – Doctors look for symptoms that are consistent with facet joint syndrome. Symptoms like stiffness and dull aching pain are common.
• Imaging Results – Ideal candidates have already undergone imaging tests or other clinical analyses that point to facet joint degeneration, injury, or mechanical stress.

In relation to that final characteristic, it should be noted that imaging alone does not confirm a facet joint problem. That’s why MBNB is recommended. Imaging may point to a problem that MBNB can confirm.

Post-Confirmation Treatment Options

Consider a patient who undergoes MBNB to confirm a doctor’s suspicion of facet joint syndrome. If the patient experiences immediate pain relief, the doctor’s diagnosis is concerned. Yet the procedure is considered a temporary fix because the pain will return as the anesthetic wears off. So what’s next?

LoneStarPainMedicine.com doctors say they have access to a number of alternative treatments for facet joint problems. One of the more common is known as radiofrequency ablation, or radiofrequency neurotomy in some circles.

This procedure uses heat-generating radio waves to create a temporary lesion on the nerve responsible for sending pain signals to the brain. As long as the lesion remains, pain relief continues. Radiofrequency ablation is considered a more permanent treatment than MBNB.

Something to Talk With Your Doctor About

Although it is just a temporary fix, MBNB is something worth talking to your doctor about if you experience chronic back or neck pain. And if your doctor is not interested in having the conversation, perhaps you can get a referral to a pain specialist.

MBNB is a fantastic diagnostic tool capable of pointing to facet joint syndrome and other facet-related issues. It is minimally invasive, quickly administered, and free of any significant risks or complications.