Diagnostic Medial Branch Blocks

Diagnostic Medial Branch Blocks

These injections are used to determine whether or not a personʼs pain would respond to Radio-Frequency (RF) Ablation. Thus, they are not in themselves a treatment but are used as a guide for further treatment.

From a patientʼs perspective they are technically similar to the cervical and lumbar facet joint injections although the actual “targets” for the needles are a few centimetres different. As with the facet joint injections they are quite quick to perform and the side effects and risks are similar.

Risks of this treatment

Immediately after the injection, your legs may feel tingly and heavy. This is because the local anaesthetic partially blocks the nerve to your legs. It will wear off after a few hours. It is important not to get out of bed until your legs feel completely normal. As with any injection, there is a very small chance of getting an infection where the needle is placed.

Every effort is made to avoid this with use of skin-cleaning solution, sterile gloves and equipment. The procedure is made as safe as possible by being performed by an experienced pain doctor. They may use x-rays to show exactly where they are putting the epidural needle and will constantly monitor you throughout the procedure. You may discuss the risks further with your pain doctor.

Pre-operative assessment & Care

If you become pregnant, have any major illnesses/hospital admissions or start taking anticoagulant drugs (for example warfarin or clopidogrel) discuss this with the pain doctor before the procedure. If you have diabetes, you may need to make some changes to your diabetes medicine or diet on the day of the procedure. You should discuss this with your pain doctor before your procedure.

On the day of the procedure:

  • Follow the instructions given to you by the Day Surgical Unit staff about when last to eat or drink.
  • Take all your usual medication including your painkillers
  • Bring all your usual medication, or a list of what you are taking with you.
  • Make sure that someone will collect you, take you home, and is available to stay with you overnight.

During the procedure

At the Day Surgical Unit your pain doctor will see you, and explain the procedure fully. Before the procedure starts a small cannula (tube) may be placed in a vein in the back of your hand through which we may give you medicines and fluids if that becomes necessary. You may be given medication (sedation) to make you feel sleepy during the injection.

An oxygen mask may be placed over your face. A needle is then placed to perform the facet joint injection. Local anaesthetic is injected. This procedure takes about 15-20 minutes. After the procedure, you may have your blood pressure, pulse and respiration rate checked.

After the procedure – what to expect

Commonly you may feel an increase in the pain coming from your back/neck for several days. The injection may take 10 days or more to relieve your pain. For some people, the injection may not work at all. You may feel weak or tired for a little while after the injection so we advise that you rest for 24 hours. During this time you should not: drive a car or operate equipment, sign any legal documents or drink alcohol.

You should continue taking your usual medication and the next day you may take a bath or shower and remove any plasters. Please contact your GP (family doctor) if you have any symptoms causing you concern and if: · There is unusual redness or swelling at the injection site · Your temperature is 38° C (100.4 F) or greater

After the procedure – what to expect

Commonly you may feel an increase in the pain coming from your back/neck for several days. The injection may take 10 days or more to relieve your pain. For some people, the injection may not work at all. You may feel weak or tired for a little while after the injection so we advise that you rest for 24 hours. During this time you should not: drive a car or operate equipment, sign any legal documents or drink alcohol.

You should continue taking your usual medication and the next day you may take a bath or shower and remove any plasters. Please contact your GP (family doctor) if you have any symptoms causing you concern and if: · There is unusual redness or swelling at the injection site · Your temperature is 38° C (100.4 F) or greater

After discharge home

To get the best out of your injection you should continue with your usual medication and be aware that the effects of the injection may not last very long at all- it is a test after all.

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Telephone: 01256 377741
Email: info@thepainteam.com

Fax: 01256 377665 Address: The Pain Team c/o The Hampshire Clinic Old Basing Hampshire RG24 7AL

Practice Manager: Karen: karen@thepainteam.com Admin: Michelle: michelle@thepainteam.com Rob Baylis private secretary & medical legal work Name: Philippa Williams Email: pippa@thepainteam.com Tel / Fax: 023 9225 6300 The Pain Team Limited Registered Company Number: 07204359 Registered in England and Wales