What is the role of medial branch blocks (MBBs) in the treatment of low back pain (LBP)?

Updated: Aug 22, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Medial branch blocks (MBBs) have traditionally been used for both diagnostic and prognostic purposes, but have demonstrated limited use potential as a therapeutic tool. The therapeutic role of MBBs was evaluated in 3 randomized clinical trials [147, 140, 148] and 3 nonrandomized clinical trials. [149, 150, 151]

Only one of the randomized trials used the appropriate criteria to diagnose facet joint pain and showed adequate long-term follow-up of the outcomes. [147] Patients with cLBP who failed standard nonoperative therapies were randomized into either a treatment or a comparison group. Both groups received MBBs with anesthetic and Sarapin; however, the treatment group also received methylprednisolone as part of the injectate. All patients reported significant relief in the first 3 months, 82% between 4-6 months, and 21% between 7-12 months. Improvements were also noted in physical, functional, psychological, and return-to-work status. In the previously cited evidence-based review by the same author, MBB were strongly supported for short-term pain relief and moderately supported for long-term relief of facet joint pain. [137]

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