Patients who have been diagnosed with spondylosis of the spine or arthritic changes of the spine leading to facet pain may benefit from interventional therapies.
Injections directly into the facet joint have decreased significantly as treatment of the nerves that supplies the joint has become more the standard-of care for chronic facet pain. These nerves can now be treated with Radiofrequency Lesioning and provide the patient with up to 48 months of pain relief. In some instances, it may be permanent.
These types of nerve blocks are called Medial Branch Blocks.
Preparing for Medial Branch Blocks
Patients should not to eat or drink for at least six hours before their scheduled procedure (if they wish to have mild sedation). Small sips of water are allowed if needed to take medications. Patients must inform their physician if they take any type of blood-thinning or diabetic medication before the procedure.
Although the injection itself will only take a few minutes, patients need to allow about 1 hour of time for the appointment. This time includes registration, physician consultation and examination, the procedure and recovery time. Patients should not drive home after the procedure, so make arrangements should be made for a friend or family member to stay.
What Happens During Medial Branch Blocks?
Patients will lie on their stomach on an X-ray table. During and after the procedure, patients will be monitored with a blood pressure cuff and blood oxygen-monitoring device. The area is cleansed with antiseptic solution and then the injection is carried out. Fluoroscopic guidance (x-ray) is used throughout the procedure to accurately locate the appropriate nerves.
What Happens after Medial Branch Blocks?
Prior to going home, the patients will be asked to make some movements to assess if they have had any change in their pain level. Patients will sometimes be given a pain log to track their pain level and location for the first 24 hours following the injection.
Patients do not need to restrict their activities; however, they should use caution and avoid activities that cause excessive back strain or stress such as prolonged sitting, bending or lifting. Patients cannot drive for at least eight hours after injection.
The local anesthetic drug given can help relieve the pain immediately, but usually only last for a few hours. In most cases, long-acting, anti-inflammatory drugs similar to cortisone are also used. It may take 2 to 5 days before the initial effect of the medication is felt.
In the majority of cases, only a local anesthetic is used. It is only meant to diagnose the proper location so that Radiofrequncy Lesioning can be performed at a later date.