Lumbar Medical Branch Block and RFA

Lumbar Medical Branch Block - for chronic low back and buttock

A lumbar medial branch block is an outpatient procedure for diagnosing and treating low back and buttock pain.

This information will explain what it is, Dr. Singer can determine if it is for you.

What are lumbar facet joints? Facet joints connect the vertebrae, the bones of the spine. They help guide your spine when you move. The lumbar region of the spine contains five vertebrae and is located in the lower back Lumbar facet joints are named for the vertebrae they connect and the side of the spine where they are found. The right L4-5 facet joint, for example, joins the 4th and 5th lumbar vertebrae on the right side. Medial branch nerves are found near facet joints. They transmit pain signals from the facet joints to your brain.

What is lumbar facet joint pain? Lumbar facet joint pain is the result of joint dysfunction, either due to injury or irritation. Pain from an irritated lumbar facet joint may range from simple muscle tension to more severe pain. Depending on which facet joint is affected, the pain may occur in an area from the lower back into the buttocks and occasionally into the legs.

How do I know if I have lumbar facet pain? If you have pain in one or more of these areas and it has lasted longer than a few months, you may have lumbar facet pain. Common tests such as x-rays or MRIs may not always show if a facet joint is causing pain.

What is a lumbar medial branch block? In a lumbar medial branch block, a local anesthetic (numbing medicine) is injected over the medial branch nerve. This stops the transmission of pain signals from the facet joint. If this reduces your pain and helps you move like normal, it may tell the doctor which facet joint is causing the pain.

What happens during an injection? Unless otherwise discussed with Dr. Singer, you will NOT be receiving sedation for this procedure. You may eat a normal meal before the procedure. A local anesthetic will be used to numb your skin. The doctor will then insert a thin needle near the medial branch nerve. Fluoroscopy, a type of x-ray, must be used to ensure the safe and proper position of the needle. Once the doctor is sure the needle is correctly placed, the anesthetic will be injected.

What happens after an injection? You will be free to get re-dressed and check out at the front desk. It may help to move your back in ways that hurt before the injection, to see if the pain is still there, but do not overdo it. You may feel immediate pain relief and some numbness in your back for a limited time after the injection. This may indicate the medication has reached the right spot. You can return to work the day after the injection.

How long can I expect pain relief? The extent and duration of pain relief may depend on the amount of inflammation and how many areas are involved. Pain relief will only last for a few hours. Any relief greater than eight hours is not the direct effect of the anesthetic but more due to relaxation of the painful muscles as a result of the needle itself. Other coexisting factors may be responsible for your pain. If your pain goes away for a short time and then returns, you may be a candidate for radiofrequency ablation (RFA) of the medial branch nerve. This procedure provides a more sustained disruption of pain signals, and more permanent pain relief.

This information is for general education only. Specific questions or concerns should always be directed to your doctor. Your doctor can explain possible risks or side effects.