Lumbar medial branch block is a nonsurgical outpatient procedure for diagnosing and treating low back pain, buttock, hip and groin pain.
The procedure entails injecting a local anesthetic which acts as a numbing agent to numb the nerve which is transmitting the pain signal from the injured lumbar facet joints to the brain.
If the patient feels relieved from the pain after completion of the procedure, the doctor will know exactly the nerve that is responsible for transmitting the pain. The lumbar medial branch block is a temporary pain-relieving procedure and a diagnostic procedure.
What is lumbar facet joint
The lumbar facet joints are the joints that connect the lower vertebrae with each other. The lower region of the spine that connects with the abdomen is known as the lumbar region.
A vertebra has two facet joints on either side. The facet joint connects and also separate one vertebra from another. Facet joint as a cushion and allow for movement, twist, and bend of the spine. It also provides structural stability and control.
What is lumbar medial branch nerve
There are nerves around the lumbar facet joint that transmit sensations and pain signals from the lumbar facet joint to the brain. These nerves are known as lumbar medial branch nerves.
They are responsible for the transmission of every sensation in the lumbar facet joint and pains to the brain. It is after the pain is transmitted to the brain before the patient will start to feel the pain.
How do know if you have lumbar facet joint pain
Pains from the lumbar joints occur from the lower part of the back through to the buttock, hip, and the groin.
If your lumbar joint is injured, you may feel pain. The pain could be mild such as muscle tension or it could be severe. You may also feel pain when the cartilage inside your joint is injured or when the ligaments surrounding the joint are injured.
If you are experiencing pain in your lower back, buttock, hip or groin for over two to three months, then you might be going through lumbar facet joint pain.
You may need to undergo diagnostic tests such as x-ray, MRI, or CT scan so that the area that is injured can be seen by your doctor. However, these diagnostic tests do not work in some situations.
Who is an ideal candidate for this procedure?
You are not an ideal candidate for this procedure if:
- You are allergic to any of the medications or anesthetic that will be used for the procedure.
- You are on a blood-thinning prescription.
- You have a disease.
- You have a blood problem.
What to do prior to the commencement of the procedure
Before undergoing the procedure, you should communicate with your specialist first. Illuminate your specialist about any ailment you may have, your medicinal history, past illnesses or diseases. Inform your physician about any medication you are currently taking.
If you are on NSAIDs drugs, you ought to stop taking them. Try not to eat or drink anything 2 hours before the procedure.
Wash up with antiseptic soup before coming and wear clothing that is free. Be at the hospital at least 30 minutes before the beginning of the procedure.
During the procedure
The specialist will request that you lay on your stomach on a procedure table while resting your head and arms in positions. Your blood pressure and oxygenation will be checked.
The skin at the territory of the injection site will be completely cleaned and an anesthetic will be utilized to numb the skin.
A needle is then injected close to the medial branch nerve. A fluoroscope is utilized to guarantee that the needle is appropriately put in the correct position.
A contrast dye might also be injected with the goal that the specialist can see obviously the situation of the needle.
After the specialist has seen that the needle is put in the correct position, a numbing medication also known as the anesthetic is injected to each targeted nerve.
It may be a single nerve transmitting the pain or it could be several nerves. Several nerves can be injected all at the same time.
After the procedure
After the injection has been given, you will be observed for around 30 minutes. You will be given instructions to follow and you will also be given a pain diary to record the recovery progress.
You may feel quick relief or numbness. This is because of the effect of the anesthetic that was given and it may keep going for a couple of hours or a couple of days.
You may or may not feel any relief from pain at an initial couple of hours after the procedure is completed. This relies upon if the nerves that were injected are really in charge of the pain transmission. If the nerves are not the ones transmitting the pain, then you won’t feel any relief.
You might be permitted to proceed with your normal drugs if you are on any prescriptions after the method. You are not permitted to take any pain-relieving prescription inside the initial 4 to 6 hours. This is to take into account the exact demonstrative aftereffect of the reason for the pain.
The primary reason why lumbar medial branch block is done is to diagnose the actual cause and nerve responsible for the pain.
After the procedure, the pain might resurface after some time. This is because the effect of the anesthetic has worn out.
For more lasting pain relief, the lumbar radiofrequency ablation procedure is carried out.
Potential risks or complications that may arise from the procedure
Much the same as each other therapeutic system, there are some potential risks or complications that may arise. The risks and complications are, however, very rare. They include:
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Bleeding
Bleeding is uncommon and just happens in patients with bleeding issues.
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Allergic reactions
Allergic reactions happen in patients that are adversely affected by any of the medications or anesthetic being utilized.
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Infections
There are instances of minor infections which may occur. Extreme instances of infections are exceptionally uncommon.
- Feeling of uneasiness or irritation at the injection site.