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Medial Branch Block

Medial Branch Block for Chronic Neck and Back Pain

A medial branch block is an image-guided diagnostic injection used to determine whether facet joints are the source of chronic neck or back pain. By temporarily numbing specific nerves that supply the facet joints, this procedure helps clarify the cause of pain and guide further treatment decisions.

At Motionis Medicine, medial branch blocks are performed as part of a physician-led, diagnosis-first approach using advanced imaging for accuracy and safety.

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Understanding the Procedure

WHAT IS A MEDIAL BRANCH BLOCK?

Medial branch nerves are small nerves that carry pain signals from the facet joints of the spine to the brain. When facet joints become inflamed or arthritic, these nerves can transmit persistent pain.

A medial branch block involves injecting a local anesthetic near these nerves to:

  • Temporarily interrupt pain signals

  • Help identify facet joint–mediated pain

  • Determine whether further treatment may be appropriate

Unlike therapeutic injections, medial branch blocks are primarily diagnostic and are used to confirm the pain source.

When Is This Procedure Used?

CONDITIONS EVALUATED WITH MEDIAL BRANCH BLOCKS

Medial branch blocks are most often used when facet joint–related pain is suspected, commonly associated with conditions such as:

Facet-mediated pain is often worse with extension, rotation, or prolonged standing.

What to Expect

HOW A MEDIAL BRANCH BLOCK IS PERFORMED

Medial branch blocks are performed using real-time image guidance to ensure accurate placement of medication near the medial branch nerves that supply the facet joints. On the day of the procedure:

  1. Patient Positioning

    Patients are positioned to allow precise access to the targeted spinal level

  2. Local Anesthesia

    The skin is cleaned and numbed with a local anesthetic.

  3. Image Guidance

    Fluoroscopy or ultrasound guidance is used to identify the correct nerve pathways

  4. Targeted Injection

    A small amount of anesthetic is injected near the medial branch nerves

  5. Recovery Monitoring

    Patients are monitored briefly before discharge.

The procedure typically takes 15–30 minutes, and patients return home the same day.

Diagnostic Purpose and Next Steps

ROLE OF MEDIAL BRANCH BLOCKS IN PAIN MANAGEMENT

Medial branch blocks are primarily used as a diagnostic tool to determine whether facet joints are contributing to spinal pain.

  • Diagnostic role

    Significant but temporary pain relief suggests that the facet joints are likely the source of symptoms

  • Therapeutic role

    inimal or no relief may indicate that pain is arising from a different structure

Because the effects of a medial branch block are temporary, the results are used to guide further treatment decisions. When diagnostic relief is consistent and meaningful, a longer-lasting procedure such as radiofrequency ablation may be considered as part of a non-surgical treatment plan.

Precision and Accuracy

IMAGE GUIDANCE & SAFETY

Image guidance allows the physician to:

  • Accurately target the correct nerves

  • Avoid nearby structures

  • Confirm appropriate placement before injection

This approach reflects modern standards in interventional spine care.

Physician Expertise

PHYSICIAN EXPERTISE

Portrait of Doctor Tanuj Palvia, MD, board-certified interventional pain physician

All medial branch blocks at Motionis Medicine are performed by Dr. Tanuj Palvia, MD, a board-certified interventional pain medicine physician with advanced training in image-guided spine procedures.

Dr. Palvia personally evaluates each patient and determines whether facet joint injections are appropriate as part of a comprehensive, non-surgical treatment plan.

Learn more about Dr. Palvia
RESULTS & EXPECTATIONS

What Outcomes Can Patients Expect?

Because medial branch blocks are diagnostic, relief is typically temporary. Patients may experience:

  • Short-term pain relief lasting hours to days

  • Improved understanding of the pain source

  • Clear direction for future treatment decisions

The response helps guide whether additional interventions are appropriate.

RELATED TREATMENTS

Based on diagnostic results, medial branch blocks may be followed by:

NON-SURGICAL SPINE CARE OPTIONS

Broader Clinical Approaches

Facet joint injections may be part of a broader non-surgical approach that includes:

FAQ'S

Frequently Asked Questions

A medial branch block targets the nerves supplying the facet joint, while a facet joint injection delivers medication directly into the joint.

Relief is usually temporary and used to guide diagnosis rather than provide long-term relief.

Most patients tolerate the procedure well. Local anesthetic is used to minimise discomfort.

If relief is significant, radiofrequency ablation may be considered for longer-lasting pain control.

Schedule a Spine Evaluation

If chronic neck or back pain is affecting your quality of life, a comprehensive evaluation can help determine whether a medial branch block is appropriate.

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