It is becoming increasingly more common for patients to seek alternative methods for managing their chronic or recurring pain symptoms, than it has been traditionally. Alleviating long-term pain is often tied to the use of prescription narcotics, which can be addictive and have adverse effects on one’s health. In instances where alternative forms of pain management may be implemented, we believe exploring those options is a great step. Below, we outline two options of alternative pain management, Medial Branch Blocks and Epidural Steroid Injections (ESIs).
Medial Branch Blocks
Facet joints are structures found in the spine, where two vertebrae connect together. The joints help to control movements of the spine and provide support and stability for the vertebrae. Pain originating in the facet joints has been listed as a main source of neck and back pain reported by patients. In addition to facet joint pain, chronic or recurring pain in a patient’s back or neck may be from prior injury, trauma, or Arthritis.
Before a medial branch block is suggested as a form or treatment, patients are usually given steroid injections to help determine the effectiveness a medial branch block would have if used. Steroid injections are administered directly into where the facet joints causing pain are located, and are composed of an anesthetic & a steroid. If the steroid injections reduce pain dramatically for a patient, a medial branch block may be suggested as the next step in a patient’s pain management plan.
Medial branch blocks target the nerves (medial branch nerves) that send sensory information to the facet joints. Instead of using only anesthetic and steroids, a needle also containing substances that destroy nerve tissue are injected. The result, if performed correctly, is a semi-permanent disruption of pain signal transmission and therefore the relief of face joint pain. While steroid injections may cause relief for a few months, medial branch blockers have been known to provide relief for up to two years. In addition to the back, medial branch blocks can be administered at the cervical level (near the neck) to provide cervical area relief as well.
Epidural Steroid Injections
In addition to avoiding the use of prescription drugs, some patients seek alternative pain management options to avoid or defer having major or invasive surgery. For lower back and leg pain, epidural steroid injections (ESIs) are often used. Much like the facet steroid injections, an epidural steroid injection also contains an anesthetic and a steroid. Instead of being injected into a facet joint, it is injected into the epidural space that surrounds the spinal cord and nerve roots. ESIs are administered in the hopes of providing relief to chronic or recurring pain, that will allow a patient to return to performing their everyday activities pain free.
Typically, up to 3 ESIs can be given over a 12-month period to a single patient, with relief from each injection lasting from 1 week up to 1 year. ESIs are often used for acute pain relief, as they are rather effective, however their long-term effects have not been as widely documented.
While both medial branch blocks and epidural steroid injections carry with them their own side effects, they are usually rare, and not long-term. If you are interested in a less invasive option than surgery, and moving away from prescription drugs, one of these options could be a great addition to your personal pain management plan. Please reach out to our team if you are interested in more information, or a consultation, about any of the options discussed in the article above. We look forward to hearing from you and assisting you on your journey to living a happy, healthy, pain free life.