In brief
- A medial branch block is a diagnostic test, not a treatment. Temporary relief confirms the facet joints are the source of your pain.
- Two sets of blocks are required for ablation eligibility.
- Track your pain levels in a pain diary for the 6 to 12 hours after the block. That record decides your next step.
- A medication hold is typically not required for this procedure unless our office directs it.
Understanding your diagnosis
Facet joint syndrome arises from inflammation or arthritis in the spinal facet joints, leading to localized back or neck pain that intensifies with backward leaning or twisting. The condition is linked to small nerves called medial branches, and blocking their signals can help identify whether the facet joints are the pain source.
The treatment
A medial branch block is a minimally invasive diagnostic procedure: a local anesthetic injection near the medial branch nerves to confirm whether the facet joints are the source of your symptoms. Temporary relief indicates a confirmed diagnosis and may qualify you for longer-term treatment such as radiofrequency ablation (RFA). Two sets of blocks are required for ablation eligibility.
Our approach
A medial branch block is a highly specific map of your pain. Under the direction of Dr. Pugh, we use live X-ray (fluoroscopy) to ensure the anesthetic is placed exactly on the nerve, so your future treatment plan is based on clear evidence rather than guesswork.
Before your procedure
Medication holds
A medication hold is typically not required for medial branch blocks, sacroiliac joint injections, or ultrasound-guided peripheral joint or bursa injections unless specifically directed by our office.
Fasting, sedation, and your ride home
- If you are receiving sedation, nothing to eat or drink for six hours before your appointment. Essential morning medications may be taken with a small sip of water only.
- We offer light or deep sedation. The level is decided by the physician and anesthesia team based on the procedure and clinical need.
- Any patient receiving sedation must be accompanied by a responsible adult driver to take them home.
Where to go
Procedures are performed at one of three facilities: our clinic at 1925 Hospital Place, ACOM at 6449 Central Park Blvd, or Hendrick South at 6399 Directors Pkwy, Suite 100. Your appointment paperwork tells you which one. Please arrive early for registration and pre-procedure preparation.
Procedure day
- Performed under live X-ray (fluoroscopy) for maximum precision.
- We use local numbing medication to ensure a comfortable experience.
- The entire procedure typically lasts about 15 minutes.
- You will be asked to track your pain levels in a pain diary immediately following the procedure.
Benefits
- Confirms the source: accurately identifies whether the facet joints are the cause of your pain.
- Minimally invasive: no surgery and no recovery.
- Evidence-based: provides the data needed to move forward with long-term relief options.
Recovery
- Return to regular activity the same day.
- Since this is a diagnostic test, the relief is temporary, usually lasting 4 to 24 hours.
- Your input is key: a follow-up is essential to determine whether you are a candidate for more permanent relief.
Afterward: what to expect
- The diagnostic window. The local anesthetic works quickly. It is critical that you monitor your pain levels over the next 6 to 12 hours while the medication is active.
- Pain diary. Please record the percentage of pain relief you experience during this window. This data is essential for determining your long-term treatment plan.
- The flare. You may feel localized soreness once the anesthetic wears off. Use ice packs (20 minutes on, 20 off) and resume baseline medications, including NSAIDs and aspirin, immediately.
Activity
Wound care
Your procedure in one paragraph
You have undergone a medial branch block, a diagnostic procedure designed to determine whether the facet joints in your spine are the primary source of your back or neck pain. We have delivered a local anesthetic, and sometimes a steroid, to the tiny medial branch nerves that carry pain signals from these joints. This diagnostic test helps us confirm whether you are a candidate for more durable treatments such as radiofrequency ablation.
Follow-up schedule
- 1
1 week
Formal assessment of how much relief the block gave, and whether you are a candidate for ablation.
Call us right away if you notice
- New or worsening leg weakness, numbness, or foot drop
- Sudden loss of bowel or bladder control
- Fever above 101.5°F, chills, or drainage at the site
- A severe headache that worsens when sitting or standing
This guide is the same information as the printed handout from Abilene Pain. It is general information and does not replace the instructions your care team gives you at your visit. Your care team: Nicolas Pugh, MD · Adrianne Anders, NP · Ted Chaka, PA.