Medial branch block injections are safe and well-tolerated by most patients.
As with any injection procedure, there are potential risks, but the side effects are typically minor and transient, and serious complications are rare.,
In This Article:
- Medial Branch Nerve Blocks
- Medial Branch Injection Procedure
- Risks and Complications of Medial Branch Blocks
- Medial Branch Block Video
Potential Side Effects of Medial Branch Blocks
Pain at the injection site is a common side effect of medial branch blocks.
Medial branch block injections typically cause mild and temporary localized side effects, such as:
- Pain and soreness
- Numbness
- Weakness in the arms and/or legs
- Bleeding and/or bruising
- Vasovagal reactions (slow heart rate, sweating, and dizziness)
If corticosteroids are used, temporary flushing, headache, increased injection site pain (also called “steroid flare"), and agitation may occur in some cases.,
The recommended treatments for these temporary effects include the application of ice and/or over-the-counter pain medications (eg, Tylenol and Advil).
See Medications for Back Pain and Neck Pain
Avoiding the use of pain medication for the first 4 to 6 hours after the injection is recommended to ensure an accurate assessment of the procedure's effectiveness.
Potential Risks and Adverse Events of Medial Branch Blocks
Potential complications of medial branch blocks include spinal cord or nerve damage.
The complications associated with medial branch block injection procedures are primarily related to incorrect needle placement and/or sensitivity to the medications used, and include,:
- Excessive bleeding and bruising
- Infection
- Allergic reaction to medication or contrast dye
- Worsening of pain
- Nerve damage, including permanent weakness of the arms and/or legs
- Spinal cord damage or paralysis
When imaging is used, the risks of nerve injury and inadvertent injection of medication into nearby blood vessels, nerves, or tissue are low.,
Potential risks of corticosteroid use in medial branch block injections
Corticosteroids used in therapeutic blocks carry a risk of significant complications due to the potential for absorption into the bloodstream, including:
- Osteonecrosis
- Decreased bone mineral density
- Reproductive hormone imbalance
- Psychiatric changes (eg, agitation, irritability, insomnia)
- Increased blood sugar (hyperglycemia)
- High blood pressure (hypertension)
- Fluid retention
- Adrenal suppression
Additionally, chronic exposure to corticosteroids from repeated therapeutic blocks and/or the presence of underlying medical conditions (eg, diabetes, osteoporosis, and heart disease) increases the risk of serious adverse events.
Long-term risks of medial branch block injections
In some cases, nerve injury and/or untreated infections may cause permanent damage, but these complications are rare.,
It is advisable to discuss the risks, benefits, and alternative treatments with your doctor before proceeding with medial branch block injections.
