Medial Branch Block

This is a purely diagnostic test to identify which patients will receive benefits from a radiofrequency ablation (RFA) procedure. An anesthetic is injected into the medial branch nerves supplying a targeted facet joint. Typically, several levels of the spine are injected in one procedure, and then pain is assessed over the next 24 hours. We will evaluate your pain response to determine if you are a candidate for RFA.

HOW DO I PREPARE FOR MY PROCEDURE?

• Take all prescribed medications as directed.
• You will be instructed by a booking coordinator to stop pain medication 24 hours prior to appointment time. PLEASE NOTE: Do NOT stop pain medication prescribed by your doctor without a consultation first.
• If you are currently taking antibiotics, you will need to wait two weeks after your last dose before having your injection.
• If you have diabetes, please eat one hour before your appointment.
• Please arrive 15 minutes before your appointment to allow enough time to check in with reception.
• Bring photo identification and your provincial health card.
• Wear comfortable clothes.
• Please do not bring children who require supervision.

WHAT HAPPENS DURING MY PROCEDURE?

• A team member will review the consent form, explain procedure details, and answer any questions.
• We will then escort you to our treatment suite where you will meet the radiologist who will clean the skin and inject a local anesthetic, similar to the freezing you get at the dentist.
• Under X-ray guidance the radiologist will guide small needles adjacent to the medial branch nerves and inject a small amount of anesthetic.
• This is strictly a diagnostic test so there is no long-term therapeutic relief. It is used as a pre-curser to RFA.
• You will be assessed post-injection by our team and, if there are no concerns, you will be free to leave.

POST-PROCEDURE INSTRUCTIONS

• First 24 hours:
  • Keep the treatment area clean. Leave the Band-Aid on. Do not shower.
  • Please keep track of your pain score every hour post injection for eight hours, and then the last entry 24 hours post injection. You will be given a log sheet to record your pain scores.
  • Only record pain scores for times provided on the sheet. Please use the pain score guide provided on the back of your log sheet. Only record whole numbers (i.e., no 2.5 or 2-3).
  • Please perform the activities that recreate your pain for the 24 hours after your injection.
  • Try not to take any pain medication for 24 hours after your injection. Only take pain medication if the pain is unbearable. Please document the time and name of the medication in the notes section of your pain log sheet.
• Resume taking your usual pain medications after 24 hours.
• Once you have completed your pain log, please send us your results immediately. You may phone, fax, or email your results to the pain therapy department (listed on the bottom of your log sheet).
• If you have pain or other symptoms beyond 48 hours after your injection, this is a normal reaction. If you have any questions, please email us at paintherapy@radiology.ca during business hours.
• Watch for infection: If you develop worsening pain, skin redness at the site of injection, or a temperature greater than 38.5°C, please proceed to an urgent care or emergency centre.

WHEN WILL I GET MY RESULTS?

• Please note this is a two-part exam. Once we interpret your results from the first test injection, you may be a candidate for the second test.
• If you are considered an appropriate candidate after having both test injections, we will place you on our waitlist.
• If you do not qualify for the RFA procedure, we will inform your referring physician. Please follow up with your referring doctor for further assessment and consultation.
• Please consult with your doctor regarding your results and any follow up exams or questions.

HOW MUCH WILL IT COST?

This exam is covered under your Alberta Health Care Plan. It is not currently offered at our Saskatchewan clinics.