Thoracic medial branch block overview

Diagnosing joint pain in the middle back

A thoracic medial branch block is a diagnostic test used to determine whether pain in the middle section of the back is arising from the facet joints in the thoracic spine.

The test works by temporarily interrupting pain signals transmitted to the brain through the medial branch nerves, using a small quantity of local anaesthetic. Where pain is significantly reduced, this indicates that the facet joints are the likely source of the pain.

A thoracic medial branch block generally lasts for 24-48 hours, but in some cases it may continue to suppress pain for longer. To accurately diagnose facet joint related pain, you may need two sets of thoracic medial branch blocks.

Learn More Contact us

Thoracic medial branch block indications and preparation

Preparing for your diagnostic procedure

A thoracic medial branch block may be recommended for back pain potentially arising from the facet joints.

As this is primarily a diagnostic procedure, it is important that your usual pain can be reproduced at the time of the procedure. You should stop taking pain medication around 5-6 hours beforehand.

If you do not have pain on the day of the procedure, we may suggest postponing it to a later date.

You should avoid undergoing any other medical procedures, such as dental treatment or a colonoscopy, within 48 hours before or after a thoracic medial branch block.

Please let us know ahead of the procedure if:

  • You are taking any antibiotics.
  • You have a pacemaker or defibrillator.
  • You are ill, in which case we may need to postpone the procedure.

You should also not drive yourself to or from the appointment.

Request an appointment Contact us

Thoracic medial branch block procedure

What to expect during your procedure

The procedure uses X-ray guidance to accurately position the injection, followed by a short observation period.

1. Positioning and anaesthetic

You will lie face down on a theatre table. A general anaesthetic agent may also be given.

2. Injection site preparation

The injection area is cleaned and numbed with local anaesthetic before a thin needle is inserted.

3. X-ray guided placement

The needle is guided into the correct position using mobile X-ray imaging.

4. Contrast and anaesthetic injection

A small amount of contrast dye is used to confirm the target area before the anaesthetic is injected.

5. Recovery and observation

You will remain under observation for around 30 minutes before being able to go home.

After your thoracic medial branch block

Recovery and monitoring after the procedure

After the procedure you are able to return home, but you will not be allowed to drive yourself home. There is no restriction on day-to-day activities. You will be asked to complete a 24-hour pain diary.

Request an appointment Contact us

Thoracic medial branch block risks

Possible complications to be aware of

A thoracic medial branch block is a relatively low-risk procedure – however all medical treatment comes with some level of risk. Possible complications may include:

Pain

Temporary discomfort may occur after the procedure.

Bleeding

Minor bleeding may occur at the injection site.

Infection

A small risk of infection is present.

Pain at injection site

Temporary soreness may occur where the needle was inserted.

Nerve damage

Rarely, nearby nerves may be affected.

Low blood pressure

Blood pressure may temporarily drop following the procedure.

Allergic reaction

A reaction to the anaesthetic or contrast dye may occur.

Ready to take the next step?

  • Comprehensive pain assessments
  • Individual treatment planning
  • Medication review and optimisation

Request an appointment Contact our team

Melbourne Pain Group Glen Waverley Head Office Outside Photo