Medial Branch Block

Medial Branch Block is an image-guided injection performed under fluoroscopy or CT to deliver targeted medication to a specific spinal structure.

It is used both diagnostically — to confirm a pain generator — and therapeutically, to reduce inflammation and break a pain cycle so rehabilitation can progress.

• Persistent radicular or axial pain despite first-line care
• Diagnostic clarification of the pain source
• Pre-surgical decision making
• Patients who prefer to avoid or delay surgery

• Day-case procedure, usually under local anaesthetic with light sedation
• Live X-ray (fluoroscopy) or CT used to position the needle accurately
• Local anaesthetic and steroid delivered to the target structure
• Patient observed briefly and discharged the same day

• Targeted relief
• Diagnostic information
• Day-case, no general anaesthetic in most cases
• Can be repeated when appropriate

• Temporary increase in pain (usually 24–48 hours)
• Bruising at the needle site
• Rare: infection, bleeding, nerve injury, dural puncture
• Steroid-related effects on blood sugar in diabetic patients

• Physiotherapy
• Medication optimisation
• Radiofrequency denervation
• Surgery

Most patients return to normal activity within 24–48 hours; the steroid effect typically builds over 1–2 weeks.

• Day 0: procedure, rest at home
• Days 1–2: light activity, occasional increase in pain
• Week 1: steroid effect starting
• Weeks 2–6: peak benefit; resume physiotherapy

• —NICE — Low Back Pain and Sciatica in Over 16s (NG59)
• —British Association of Spine Surgeons (BASS)

This information is for general patient education and is not a substitute for an individual consultation. Always seek personalised advice from a qualified spinal specialist.