Lumbar Medial Branch Injection

What is a lumbar medial branch nerve injection?

A lumbar medial branch injection (sometimes referred to as block) is a procedure used to diagnose pain arising from the joints in the back of the lower (lumbar) spine.  These joints are called the lumbar facet joints.  Lumbar facet pain is seen with degenerative conditions and is more common with older age groups.  Lumbar facet pain may occur with degeneration of an injured disc.  The decreasing cushion from a degenerative disc places stress on the lumbar facet joints.  Lumbar facet pain can also occur after falls and motor vehicle accidents.

How is a lumbar medial branch nerve injection performed?

To perform a lumbar medial branch injection, the doctor places a small needle through the skin and navigates the needle via x-ray guidance to the site of the lumbar medial branch nerve, along the bony lower spine.  A lumbar medial branch injection works by anesthetizing the nerve that transmits pain impulses from the facet joint, providing relief until the anesthetic wears off.  This allows the physician to examine the lower back and see if it is now pain free.  It’s important to note that a lumbar medial branch injection is a diagnostic test, resulting in temporary pain relief that lasts long enough for your doctor to diagnose your condition.  In order to minimize false negative results the procedure is usually repeated.  This is called a confirmatory medial branch block.  If the initial and confirmatory injection results in substantial pain relief it will be followed by a procedure that brings long lasting relief.

How long will the procedure take?

Allow yourself an hour to be prepared for the procedure.  The actual procedure will take about 15 to 30 minutes.  After the procedure you will recover for 30 minutes to an hour before going home.

What is the recovery like?

You can generally return to normal activities by the next day.  you can shower the same day as the procedure.

The 4 Pillars of Treating Chronic Spinal Pain

George Rappard MD discusses the 4 key pillars of spine care. The 4 pillars are physical therapy and chiropractic care tailored to your condition, appropriate selection of medical therapy, pain injections targeting your specific pain source and, as a last result, minimally invasive motion and stability preserving spinal surgery performed as an outpatient procedure. Through effective use of the first 3 pillars only about 5% of our patients need to go on to have back surgery or neck surgery.

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