What is a cervical medial branch block?

The cervical spine (neck) is made up of even vertebrae. The vertebrae are joined together by joints called facet joints, one on the right and left side between each vertebra. Facet joint disease is felt to be frequent causes of pain particularly after a whiplash injury. Each facet joint has two little nerves that detect pain. These are known as Medial Branch Nerves. In a Medial Branch Block we numb these nerves with local anesthetics. If the pain goes away with the anesthetic, then it would suggest that the pain is coming from the facet joint(s). If significant relief is obtained on two occasions from these blocks, then definitive treatment can be accomplished by performing a Radiofrequency Neurotomy.

What will happen during the procedure?

You will be asked to lie on your side and will be made as comfortable as possible. Using an X-ray machine for guidance, Dr. Harries will position a very fine needle correctly and then inject a small amount of X-ray dye. If everything appears satisfactory, the numbing medication will then be injected. This procedure will then be repeated for each nerve.  After the procedure you will be taken to the recovery area and observed for about 20 minutes. In the illustration the red dots mark the position of the nerves. Your pain score will be recorded. After the procedure it is important that you maintain a pain diary for 48 hours.

Can I be sedated for the procedure?

Sedation is best avoided as it may reduce the accuracy of this diagnostic block.

What are the risks of the procedure?

This is a very safe procedure. Feeling faint is the most common problem patients experience. Allergic reaction to medications, bruising and infection are also very rare complications. After any procedure it is possible to develop an increase in pain particularly from muscle spasms. Unsteadiness can occur when a block is performed at or above the C3 level.

What next if my pain is far better after the blocks?

If your pain is dramatically improved on two occasions with the blocks then you will be a candidate for Radiofrequency Neurotomy. Please see the separate leaflet on Radiofrequency Neurotomy.

When can I return to work?

Most patients can return to work the following day.

When can I drive?

You should not drive until the next day. Don’t forget to bring a driver with you on the day of your procedure.

What research is there on the effectiveness of this procedure?

Medial branch blocks are a test used to determine your suitability for radiofrequency neurotomy and so are best described as a test not a treatment. Research studies show that Radiofrequency Neurotomy is an excellent procedure for neck pain providing consistent relief has been obtained from medial branch blocks. Success rates of up to 85% have been achieved with radiofrequency neurotomy when treating facet pain in the neck. .