Medial branch blocks (MBBs) are targeted diagnostic injections used to help determine whether facet joints, the small stabilising joints between vertebrae in the spine are the source of your back or neck pain.
These joints can become inflamed due to arthritis, injury, or degeneration, leading to localised pain that may also radiate to the shoulders, buttocks, or upper thighs (depending on the affected region).
Rather than injecting directly into the joint, a medial branch block involves injecting a small amount of local anaesthetic (and sometimes steroid) near the medial branch nerves tiny nerves that carry pain signals from the facet joints to the brain.
The primary purpose of a medial branch block is diagnostic to confirm whether your pain is truly arising from the facet joints.
If you experience significant pain relief (even if temporary) following the injection, this suggests the facet joint is a likely pain source. This result helps your doctor determine whether a longer-lasting treatment such as radiofrequency ablation (RFA) is appropriate.
In some cases, medial branch blocks may also provide short-term pain relief, allowing you to resume activity or physiotherapy.
01
Facet joint osteoarthritis
02
Chronic neck pain
03
Chronic lower back pain
04
Postural or mechanical spine pain
05
Persistent back pain after spinal surgery
If significant relief is experienced, your doctor may recommend radiofrequency ablation to provide longer-term pain control.
Most people tolerate medial branch blocks very well. However,
as with all procedures, there are some risks:
Medial branch blocks are particularly useful in:
We typically use:
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Originally from England, Sally graduated from St George’s Hospital, University of London in 2004 with a BSc (First Class Hons) in Physiotherapy. Since settling in Australia, Sally has worked in private practice and in the public hospital setting across Sydney.
Sally gained a Masters in Medicine Pain Management from the University of Sydney in 2019 and is a Titled Pain Physiotherapist (as awarded by the Australian Physiotherapy Association).
In addition to private practice, Sally currently works as a Senior Physiotherapist at Westmead Hospital Pain Management Service.
Sally is highly skilled in assessing, diagnosing and treating people who experience chronic pain. She enjoys working with injured workers and CTP claimants. She has a deep understanding of the impact of pain on the whole person and on their functioning in daily life. In partnership with her colleagues, Sally enjoys applying her knowledge and clinical skills to provide a safe space for exploration of the physical and emotional meaning of pain and for recovery of function.
Qualifications and Experience
Dr. Adam is a Fellowship-trained Pain Medicine Specialist with a Fellowship from the Faculty of Pain Medicine (FFPMANZCA) and a Master of Pain Medicine from the University of Sydney. He is dedicated to the comprehensive management of chronic pain across all age groups.
Dr. Adam trained in adult pain medicine at Liverpool Hospital, Nepean Hospital, and the Department of Pain Medicine, and completed additional training in paediatric chronic pain at The Children’s Hospital at Westmead. He currently serves as a Staff Specialist at Westmead and St George Public Hospitals (NSW Health), and is a Visiting Medical Officer (VMO) at Liverpool Public Hospital, St George Private, Sydney Southwest Private, Holroyd Private, Norwest Private, and Nepean Private Hospitals.
He adopts a whole-person, multidisciplinary approach rooted in the socio-psycho-biomedical model, utilising both pharmacologic and interventional techniques. These include:
Dr. Adam is an Authorised Prescriber of Medicinal Cannabis and holds a Diploma in Medicinal Cannabis. He is also certified in Opioid Treatment Programs, including Methadone. His areas of interest include opioid dependence management, medicinal cannabis, and interventional pain procedures.
He also completed advanced training in Virtual Reality Therapy for chronic pain and mental health disorders in Barcelona, Spain, and has further qualifications in Focused Psychological Strategies, Cognitive Behavioural Therapy (CBT), and Clinical Hypnosis.
Qualifications:
