Lumbar Medial Branch Block

For Chronic Low Back Pain

A lumbar medial branch block injection is an outpatient procedure for diagnosing and treating lower back and leg pain.

What are lumbar facet joints?

Facet joints connect the vertebrae, the bones of the spine. They help guide your spine when you move. The lower back area of the spine is called the lumbar region. It contains seven vertebrae. Facet joints are found on both sides of the spine. Each is about the size of a thumbnail. 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, joint the 4th and 5th 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 the lumbar facet joint pain?

You may feel pain if a lumbar facet joint is injured. Sometimes it feels like muscle tension. Other times it can be severe pain. The cartilage inside the joint may be injured. Other times only connecting ligaments surrounding the joint are injured. Facet pain also depends on which facet joint is affected. Lumbar facet pain can occur in an area from your lower back down to your buttock.

How do I know if I have lumbar facet paint?

If you have pain in one or more of these areas when you turns your lower back, and it lasts longer than two 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 near the medial branch nerve. This stops the transmission of pain signals from the facet joint. If this reduces your pain and helps you move your lower back like normal, it may tell the doctor which facet joint is causing the pain.

What happens during an injection?

What is a lumbar RFA?

RFA uses radiofrequency energy to disrupt nerve function. When this is done to a lumbar medial branch nerve, the nerve can no longer transmit pain from an injured facet joint.

What happens during an RFA?

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, may be used to ensure the safe and proper position of the needle. The doctor will then check to make sure it is at the correct nerve by stimulating it. This may cause muscle twitching and provoke some of your pain. Once the doctor is sure the needle is correctly placed, the nerve will be numbed. Radiofrequency energy will then be used to disrupt the medial branch nerve. This is often repeated at more than one level of the spine. This is not a permanent procedure and the nerve usually recovers over time and the pain can return.