What is a Cervical Medial Branch Block?
A cervical medial branch block is a procedure that involves injecting a local anaesthetic over the cervical medial nerves in order to temporarily relieve pain and irritation by preventing pain signals from radiating from the cervical facet joint.
The medial branch nerves are the tiny nerves stemming from the facet joints responsible for transmitting pain signals from the facet joints to the brain. Cervical facet joints, also known as zygapophysial joints or z-joints, are located in the cervical vertebrae of the spine.
When is a Cervical Medial Branch Block Used?
The medial branch block is often used as a way to diagnose and/or treat pain, inflammation, or other symptoms caused by irritation or damage to the cervical medial nerves located in specific facet joints.
While the procedure is often used as a way to provide temporary relief of pain and discomfort, the primary purpose of a cervical medial block is diagnostic in nature — once administered, if the patient experiences short-term symptom relief, a doctor is able to confirm the cervical facet joint(s) as the source of the issue and recommend treatment for long-term relief, including medial branch radiofrequency neurotomy.
| Stage | What happens |
|---|---|
| Before | You're positioned, the skin is cleaned and numbed, and live imaging (fluoroscopy or ultrasound) guides the needle |
| During | The medication is placed precisely at the small nerves feeding your neck facet joints; most people feel pressure more than sharp pain |
| After | You rest briefly and go home the same day — arrange a driver if you received sedation |
How is it Administered?
Like most injections involving the spine, a cervical medial branch block is performed under light local anaesthesia. Using a fluoroscopy (live x-ray), a physician will direct a tiny needle to the affected medial nerve. Once in place, a small amount of contrast dye is injected to ensure the treatment is being applied to the correct medial nerve. Upon confirming the correct nerve(s), anaesthesia is injected into the same nerve(s).
What are the Risks?
Like any medical injection, there are potential risks and complications. While the risk of complications is low, they can include: allergies, infection, and worsening symptoms — including pain, weakness, and numbing.
How Effective is it?
When treating the temporary pain relief associated with a cervical joint injury or medial nerve irritation, cervical medial branch blocks have demonstrated to be very effective. However, if the nerves receiving the treatment are not the correct source of the pain signals, there will be no relief of pain or other symptoms.