Medial Branch Block Injections for Facet Joint pain

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Medial Branch Block Injections for Facet Joint pain

IMPORTANT: Please inform the doctor or nurse if you are pregnant or likely to be
pregnant as this injection is performed with the aid of x-ray machine. Please also
inform the staff if you are taking blood thinning medication.

Frequently asked questions and the answers regarding Medial Branch Block
injections:

What is a medial branch block injection?
It is an injection of local anaesthetic around a nerve (medial branch) that supplies the
facet joint in your spine.

What is the purpose of the injection?
It is a diagnostic injection for suspected facet joint pain. The anaesthetic can block the
nerve to stop sending messages to the brain.

How long does the injection take and will the injection be painful?
The actual injection only takes a few minutes.
You will feel some discomfort on insertion of the needle.

Will I be put to sleep for this procedure?
No, this injection is performed using a local anaesthetic.

How is the injection performed?
The injection is carried out in a treatment room.
X-ray imaging will be used to locate the correct joint, so if you think you may be
pregnant you should speak to a member of staff before the treatment is performed.
The injection is usually carried out with the patient lying on their stomach. The Doctor
will identify the facet joints, which need injecting by pressing on your back. Once the
painful joints have been located, the area in which the injection will be given will be
cleaned with antiseptic solution, and sterile sheets will be placed around the injection
site.

What should I expect after the injection?
Immediately after the injection you may find that your pain has gone or is rather less.
This will be due to the local anaesthetic, which has been injected and may only last for
a few hours.

What should I do after the procedure?
We advise you NOT TO drive for 24 hours following the injection, take it easy for the
rest of the day and then resume normal activities as tolerated. (Driving may invalidate
your car insurance). You will be asked to fill in a pain chart every hour or so after
the procedure to help us assess the effects of the injection on your pain. It is
important you complete this form.

How long will the injection last?
The immediate effects from the local anaesthetic will wear off in a few hours.

Benefits
Medial branch blocks are for suspected facet joint pain and are normally provided as a
one off diagnostic injection. This is to ascertain how much the facet joint is contributing
to your pain. Depending on your response to the injection a further procedure can be
arranged after your review appointment, aimed at giving longer pain relief.

Risks & Complications
 For some people the injection may not work at all.
 Frequently there is a temporary exacerbation of your pain and stiffness after
medial branch block injections.
 Currently there is no evidence to suggest that Medial Branch block injections
make spinal pain permanently worse.
 Temporary (few hours) leg weakness due to local anaesthetics used.
 Bleeding from injection site.
 As with any injection there is a slight chance of getting infection where the
needle is placed.
 There is a small risk of nerve damage (less than 1:10,00 chance) which may
be severe and permanent e.g. numbness, new nerve pain, pins and needles,
weakness etc.

Alternative treatments
Apart from medial branch blocks, there are other pain reducing therapies which may
help including:
 Pain reducing medicines
 Relaxation
 Self help
 TENS
 Physiotherapy
 Functional Restoration Program

CONTACTS
Should you require help or advice please contact your Specialist Nurse:
Worcestershire Royal Hospital
Monday – Thursday
Tel: 01905 733313
Answer Phone Service
Kidderminster Treatment Centre
Tel: 01562 512 379
WAHT-PI-0011 Version 1 Approval Date: 10/07/18 Review Date: 10/07/20
Owner: Chronic Pain Management Service
Evesham Community Hospital
Tel: 07436 038 681
Or
Your local GP/Primary Care Unit
If your symptoms or condition worsens, or if you are concerned about anything,
please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you
and your loved ones. If you have any questions or concerns, please do speak with a
member of staff on the ward or in the relevant department who will do their best to
answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well
and where improvements can be made. There are lots of ways you can share your
experience with us including completing our Friends and Family Test – cards are
available and can be posted on all wards, departments and clinics at our hospitals. We
value your comments and feedback and thank you for taking the time to share this with
us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the
nurse in charge or the department manager in the first instance as they are best
placed to answer any questions or resolve concerns quickly. If the relevant member of
staff is unable to help resolve your concern, you can contact the PALS Team. We offer
informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf,
if you feel unable to do so, to resolve your problems and where appropriate refer to
outside help.

If you are still unhappy you can contact the Complaints Department, who can
investigate your concerns. You can make a complaint orally, electronically or in writing
and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PET@nhs.net
Opening times:
The PALS telephone lines are open Monday to Thursday from 8.30am to 4.30pm and
Friday: 8.30am to 4.00pm. Please be aware that a voicemail service is in use at busy
times, but messages will be returned as quickly as possible.
If you are unable to understand this leaflet, please communicate with a member of
staff.

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