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Medial Branch Block in SI Joint?

durrrrddurrrr Posts: 10
edited 06/11/2012 - 8:57 AM in Sacroiliac (SI) Joint Problems
I have once again been to the pain clinic and had my 3rd injection and he decided to do a medial branch block with just lidocaine to verify as a pain source. He had done 2 prior as diagnostic and said then that since the pain went away about 80% right after it was the pain source. If that was the case then why do the block and now he suggests the ablation at the SI Joints. I am doing everything to avoid a fusion but feel like the PM doc keeps me coming back and running up a huge bill. He said that he wasn't a fan of ablation but suggested it any way as a last resort. Has anyone had these issues and did they work? Also the damn Medial Branch Block was by far the most painful injection I have had other than the discogram prior to my fusion. In that case will the ablation be just as painful? He will be doing all 4 nerves from what I understand and that means 4 seperate needles once again. Anyone that has any answers or advise please feel free to shed some intellect please..



  • Does the median branch block innervate the SI joint. I thought it only innervated the facet joints, and a lateral branch block innervated the SI joint???

    If your pm doc is doing a median branch block for facet pain, which levels did you have blocked?

  • I was told while there he did a Median Branch Block however after looking at the fluroscopic image they gave me the 4 injections were in the SI Joint below my l5-s1 fusion site. I could see the pedicle screws and rods above the injection needles. It says in my paperwork it was a Lateral block and was on the s1-s3 lateral branches and l5-s1 primary dorsal rami. I am just frustrated and also feel like I am quickly running out of options. In 3.5 yrs I have had 2 surgeries, 12 or more ESI injections, 2 facet injections at l5-s1 and 1 RFA in the same facet joint. The list could go on and on, and yet I am still in more pain than I was when I had my MVA. I just want to live a some what pain free life. I have 20 month old that I am missing way to much things due to the fact they can't seem to fix me. 1 pain source they ease and the others become worse. This pain is by far the worse and getting worse all the time. PM says it is a combination of things but the fusion is stressing the joint to the max.
  • I understand your frustration. If you had a diagnostic L5 medial branch block and lateral branches at S1, S2, and S3 and noticed at least a 75 percent change of your painful symptoms with provocative movements and it was repeated for consistency and positive then I would consider ablation of those nerve endings. There is more consensus now that before considering RFA of the sacroiliac joint mediated pain you should have the nerve endings that will be heated anesthetized prior considering ablation technology to reduce your painful symptoms. If this does not work for at least 9 months where the symptoms are minimal then I would consider minimally invasive sacroiliac joint fusion using IFUSE. Hope this helps. best
    Amish R Patel DO, MPH
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