Medical Branch Injections


InjectionsA medial branch is a nerve that innervates the facet joint. You can inject the facet joint with steroid or block the medial branch for pain caused by facet arthritis. Some doctors prefer to perform medial branch nerve blocks instead of facet joint injections when the joints cannot be entered for anatomical reasons, usually due to arthritis.


  • It is done using fluoroscopy imaging (x-ray) with intravenous sedation. You would lie on your chest for the injections. The needles would be inserted lateral to the spine on both sides.
  • Usually 1.0 ml of local anesthetic is injected on the nerves at each level.
  • It is a day procedure and after a short recovery room stay, you can go home.


The local anesthetic lasts only a few hours.  The pain relief will potentially last a few days or a few weeks. This result would be considered successful, and a radiofrequency procedure would follow to burn off these nerves for extended pain relief.


Local soreness can occur.