Learning About Medial Branch Block and Neurotomy

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What are medial branch block and neurotomy?

Views of spine and vertebrae

Facet joints connect your vertebrae to each other. Problems in these joints can cause chronic (long-term) pain in the neck or back. They can sometimes affect the shoulders, arms, buttocks, or legs.

Medial branch nerves are the nerves that carry many of the pain messages from your facet joints.

Radiofrequency medial branch neurotomy is a type of medial branch neurotomy that is used to relieve arthritis pain. It uses radio waves to damage nerves in your neck or back so that they can no longer send pain messages to your brain.

Before your doctor knows if a neurotomy will help you, he or she will do a medial branch block to find out if certain nerves are the ones that are a source of your pain. You will need two separate visits to the outpatient centre or hospital to have both procedures.

How is a medial branch block done?

The doctor will use a tiny needle to numb the skin where you will get the block. Then he or she puts the block needle into the numbed area. You may feel some pressure, but you should not feel pain. Using fluoroscopy (live X-ray) to guide the needle, the doctor injects medicine onto one or more nerves to make them numb.

If you get relief from your pain in the next 4 to 6 hours, it's a sign that those nerves may be contributing to your pain. The relief will last only a short time. You may then have a medial branch neurotomy at a later visit to try to get longer relief.

It takes 20 to 30 minutes to get the block. You can go home after the doctor watches you for about an hour. You will get instructions on how to report how much pain you have when you are at home.

You will need someone to drive you home.

How is medial branch neurotomy done?

The doctor will use a tiny needle to numb the skin where you will get the neurotomy. Then he or she puts the neurotomy needle into the numbed area. You may feel some pressure. Using fluoroscopy (live X-ray) to guide the needle, the doctor sends radio waves through the needle to the nerve for 60 to 90 seconds. The radio waves heat the nerve, which damages it. The doctor may do this several times. And he or she may treat more than one nerve.

It takes 45 to 90 minutes to get a neurotomy, depending on how many nerves are heated. You will probably go home 30 to 60 minutes later.

You will need someone to drive you home.

What can you expect after a neurotomy?

You may feel a little sore or tender at the injection site at first. But after a successful neurotomy, most people have pain relief right away. It often lasts for 9 to 12 months or longer. Sometimes the pain relief is permanent.

If your pain does come back, it may mean that the damaged nerve has healed and can send pain messages again. Or it can mean that a different nerve is causing pain. Your doctor will discuss your options with you.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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