Doctor insights on:
Bilateral Lumbar Medial Branch Block
I am having headaches after my bilateral l4/5, l5/s1 lumbar facet medial branch block. Is this normal.
Wait and watch: Typically no reason to have headaches after mediial branch block. Potentially may happen IF the needle accidentally went too deep and caused spinal fluid leak but still the headache in that case would be constant with some change with position (lying down versus sitting up). Alternatively could be from steroids if used for block. Best to ask the office that did the block. ...Read more
Why would lumbar facet steroid injections work but when I did the medial branch block to see if a rhizotomy would help, it did nothing?
Muscle pain: Often the lumbar paraspinal musculature can also be the issue. Because the facet joint helped it suggests that the steroid actually improved pain where as the anesthetic only mbb didn't. The other question is that are their other structures that could cause pain like disc, annular tears, muscles, etc. ...Read more
I was consented for Si joint and medial branch block. On discharge note it says that I've had si joint and sacral ala injections, is this branch block?
NO!: A sacral block is a block of the sacral nerve roots. A medial branch block is a block of the nerves that serve the facet joints, Two very different procedures and two very different anatomic locations. Perhaps the doctor/operator changed his mind when seeing what was present on your imaging. ...Read more
I have a parasitic infection (unspecified at the moment). Is it safe to have a medial branch block?
Facet Joint injections are useful for controlling referred pain from your spine.
Most parasitic infections do not affect your spine!
Trichinella affects your muscle
Neurocysticercosis the brain!
Toxolasmosis can affect muscle and brain!
Depends on the parasite and its body location!
Most parasites are in the GI tract! ...Read more
Facet Joint Pain: Radiofrequency procedures work well if a previous facet injection or medial branch block was performed with greater than 75-80% relief that was obtained. This is used to determine pain from facet joints. As with anything there are failures, but quite low if the block worked well. Risks are the same as with any spine procedure, no different. Rare that you would be worse off afterwards. ...Read more
Cervical medial branch block with DEXA lidocaine gave me 1 day of neck pain relief. After 1day neck pain again. Ok to Proceed to radiofreq ablation?
Be patient. Some times it takes a few weeks for DEXA to get effect. Ablation is a serious procedure with some side effects and no warranties. Rec. See your pain management specialist for medication adjustment (e.g. tramadol, relafen, (nabumetone) Lidocaine 20% patch, etc.)
Also cognitive behavior therapy. East-West integration medicine.
Take care. ...Read more
Medial branch block: Mbb stands for medial branch block. The medial branch is a small branch of the spinal nerves that supplies sensation to the facet joints, which are the joints in the back of the spine. L4 and L5 refer to the specific spinal nerves in the lower back (lumbar spine). Likely this procedure would be performed for somebody with pain due to facet joint arthritis at l5-s1 on both sides (bilateral). ...Read more
Not very, may need..: The sympathetic nerves coming out of the lower spine, lumbar, send pain impulses down the legs when overstimulated in problems like herniated lumbar discs, severe degenerative arthritis, tumors pressing on lower spinal cord... If pain or arthritic meds, electrical stimulation devices (implantable), epidural injections, morphine pumps all don't control pain, may need to destroy pain nerves to legs. ...Read more
Mononeuropathy: Yes as long as it is painful mononeuropathy ...Read more
Three sets of lumbar sympathetic blocks? How much time in between for all three? Weeks or months?
2-4 weeks: Most physicians wait about 2-4 weeks between blocks and limit it to 3 in a 6 month period ...Read more
Highly Variable: My experience in my patients is that for the most part nerve blocks (whether in the lumbar or cervical spines) are not overly successful in terms of duration or amount of relief. The reason is simple. That type of pain management is purely symptomatic & never treats the cause. Pain blocks will NEVER help numbness since that is the result of the neuropathy which is what has to be fixed. ...Read more
Variety of reasons: A lumbar sympathetic block is performed to block the sympathetic nerves that go to the leg on the same side as the injection. This may in turn reduce pain, swelling, color, sweating and other unusual changes in the lower extremity and may improve mobility. It is done as a part of the treatment of Reflex Sympathetic Dystrophy (RSD), Sympathetic Maintained Pain, Complex Regional Pain Syndrome and Herpes Zoster (shingles) involving the legs. Certain patients with neuropathy or peripheral vascular disease may also benefit from lumbar sympathetic blocks. ...Read more
For Back Pain: Lumbar facet injections are meant to be diagnostic and not therapeutic to see if the facets are the cause of back pain. They should always be done under fluoroscopic guidance and pain always should be recorded on a scale for 6 hours following the procedure. If greater than 50% relief for at least six hours this proves facet mediated pain and a rhizotomy may be indicated for longer lasting relief. ...Read more
Lumbar nerve: A lumbar nerve block is 1 way to treat pain caused by compression of a lumbar nerve root. It can be done " blind" or via fluoroscopy or us guidance. Local anaesthetic and a steroid is injected close to the nerve. If the correct nerve location is identified, the pain will resolve. ...Read more
3-6 hrs: But vaires can have effects for weeks ...Read more
Nerve: Medial branch nerve block.Get a more detailed answer ›
Varies: Some doctors complete these blocks in quick succession. Others space them periodically once results ware off. Apparently your MD is addressing CRPS symptoms following a surgery with residuals but we need more information and I am making some assumptions. There are other adjunctive approaches to explore at the same time we can discuss further or you can do with your Physical Therapist.Keep me posted ...Read more
Epidural steroids: Normally the effects are seen within 24-48 hours but can take as long as 1 week. It depends on several factors such as the amount of inflammation, the cause for your never root pain, degree of disc herniation, continuation of activities that may cause the disc to flare up etc. If it does not give you much relief after the initial 2 days, the problem may be whether the drug went to the right place! ...Read more
Depends: It depends on what the expectations were with the administration of the block. Suggest you discuss this with your physician who was involved in recommending this procedure and/or the treating physician, if different. ...Read more
How long should the first lumbar sympathetic block provide me relief to consider getting a second?
Variable: Sympathetic block gives variable amount of relief. For sympathetic mediated pain I've seen relief in my patients for a month. For blood flow problems, the relief can be very short lived. The sympathetic blocks may be a test to see if pain is sympathetic mediated and there be other ways to get relief. Talk to your doctor about it. Goodluck ...Read more
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