Medial Branch Block

What is a Medial/ Sacroiliac Lateral Branch Block?

hanna-11The Medial Branch Block refers to the sensory nerves that carry pain signals from the facet joints to the brain. The Sacroiliac Lateral Branch Block refers to the sensory nerves that carry pain signals from the sacroiliac joints to the brain.  Each block is an injection of lidocaine around the sensory nerves that is temporarily blocking the pain signals.  The Branch Block is a temporary diagnostic test that is used to find a particular joint that is causing the pain.  It is usually preformed prior to a Radiofrequency Ablation to verify that the patient is a candidate for the procedure.  The patient will need to have a 50% relief of pain or higher to continue on with the RFA.

How does a Branch Block relieve my pain?

The Branch Block temporarily relieves pain around the sensory nerve when the lidocaine is injected around the joint, stopping the pain signal from the nerve to the brain for a short time.  The effect is only temporary as it is a diagnostic test only.


Dr. Ashraf Hanna performs a Cervical Medial Branch Block at the Florida Spine Institute.

What can I expect during and after the procedure?


  • The procedure usually takes 15-30 minutes
  • The patient lies flat on his/her abdomen
  • The area of the injection is cleaned and numbed with lidocaine
  • The patient is put under with a light sedation
  • Using live X-Ray (fluoroscopy) for guidance, the physician inserts the needle towards medial (facet joint) or lateral nerve branch (sacroiliac joint)
  • Once placement is confirmed, lidocaine is injected around the sensory nerve


  • The patient is usually monitored for 15-30 minutes before being discharged.
  • The patient must have a driver
  • Patients are usually asked to rest the day of the injections
  • Normal activities can be typically resumed within 24-48 hours following the injection, it is common to experience an increase in pain once the numbing medicine wears off.

Published Clinical Evidence

Transverse process and needles of medial branch block to facet joint as landmarks for ultrasound-guided selective nerve root block.

Medial branch neurotomy in low back pain.

Pulsed radiofrequency application in the treatment of chronic pain.

Diagnostic nerve blocks in chronic pain.