Cervical Medial Branch Injection

What is a cervical medial branch injection?

A cervical medial branch injection (sometimes referred to as a block) is a procedure used to diagnose pain arising from the joints in the back of the neck (cervical spine).  These joints are called the cervicalfacet joints.  Cervical facet pain is seen with degenerative conditions and is more common with older age groups.  Cervical facet pain can also occur after a fall or after a motor vehicle injury.  A forceful flexion and extension of the neck may occur, called a whiplash.  When there is chronic neck pain (pain lasting more than 8-12 weeks) after a whiplash injury, cervical facet injury is the culprit most of the time.

How is a cervical medial branch nerve injection performed?

To perform a cervical medial branch injection, the doctor places a small needle through the skin of the side of the neck and navigates the needle via x-ray guidance to the site of the cervical medial branch nerve, along the bony spine.  A cervical medial branch block works by anesthetizing the nerve that transmits pain impulses from the facet joint, providing relief until the anesthetic wears off.  This allows the physician to examine the neck and see if it is now pain free.  It’s important to note that a cervical medial branch block is a diagnostic test, resulting in temporary pain relief that lasts long enough for your doctor to diagnose your condition.  In order to minimize false negative results the procedure is usually repeated.  This is called a confirmatory medial branch block.  If the initial and confirmatory injection results in substantial pain relief it will be followed by a procedure that brings long lasting relief.

How long will the procedure take?

Allow yourself an hour to be prepared for the procedure.  The actual procedure will take about 15 to 30 minutes.  After the procedure you will recover for 30 minutes to an hour before going home.

What is the recovery like?

You can generally return to normal activities by the next day.  you can shower the same day as the procedure.

The 4 Pillars of Treating Chronic Spinal Pain

George Rappard MD discusses the 4 key pillars of spine care. The 4 pillars are physical therapy and chiropractic care tailored to your condition, appropriate selection of medical therapy, pain injections targeting your specific pain source and, as a last result, minimally invasive motion and stability preserving spinal surgery performed as an outpatient procedure. Through effective use of the first 3 pillars only about 5% of our patients need to go on to have back surgery or neck surgery.

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