Medial Branch Blocks

My first MBB worked exactly as advertised. Got a little over 2 days of relief. When the pain came back, it was worse. 

Just had my 2nd MBB today (with anesthesia both times) and I’m in slightly more pain than I was to begin with. Zero relief. 

I’m 32 years old and I’ve been in serious chronic pain for the last year. I’m almost out of money for treatments and after the first successful MBB I thought I’d get the radiofrequency ablation, combined with PT and the chiropractor and I’d finally be able to get back to my life. Now I’m starting to panic. 

Anyone else have this problem? First one worked, 2nd one didn’t? And what was your experience?



  • L4_L5LL4_L5 Posts: 1,189
    edited 06/30/2019 - 5:54 AM

    Welcome to the forum. Glad you’re here as we have some things in common. 

    Have you had the RFA? Are you not a candidate for an RFA?

    Did your MRI mention anything beyond minor disc bulge? 

    I only ask because the pain management doctor I saw said he doesn’t do injections on patients who only have a minor disc bulge and you mentioned on the other thread you didn’t have anything significant on your MRI. 

    To me (my own personal view) an annular tear and/or herniated disc causing nerve root impingement is a significant injury while a minor disc bulge might be asymptomatic.

    I had 24 hours of relief from my third injection (3/4), The other three injections (1, 2 and 4) did nothing.

    I have bilateral neural foraminal stenosis due to a bulging disc at L4-L5 (the most recent issue that’s been found) but nothing serious enough to rise to requiring surgery apparently.

    However, I’ll be seeing a new neurosurgeon in two weeks for an additional opinion.

    Once again good to have you here.

  • @L4_L5 thank you. It’s nice to find other people going through what I’m going through. It feels like no one else believes me because I’m young and I’ve always been athletic and active, and now I’m a shell of my former self. 

    I haven’t had the RFA yet. My insurance required a second MBB before the RFA but now the second MBB hasn’t done anything. I mentioned in the other thread the results of my MRI

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  • Jerome001Jerome001 Cocoa Beach, FloridaPosts: 276

    DWTGU, Some people post that they had positive results from this type of treatment while others do not. I'm in the latter category as I did not get any relief from MBB and other treatments and injections. Unfortunately, the only things that helped me were pain meds and surgery. It is very said that you have chronic pain at your age. I hope you find someone that can help you. Good luck, Jerome

  • Your MRI results are very similar to mine. 

    The pain doctor said it best when he said a larger herniation is not always more painful than a smaller one. And oftentimes the smaller ones can cause just as much pain and neurological deficiency as a large herniated disc.

    I was told that thecal sac impingement is not a big deal most of the time, as it’s comparable to someone gently pressing their finger into a water balloon.

    However, the pain doctor mentioned that in cases where there’s a herniated disc with thecal sac impingement and there’s corresponding neurological symptoms appearing in the locations (body parts) innervated by the specific level of disc herniation then a neurosurgeon consult is a good idea.

    For us folks with only scant or sparse evidence of abnormality such results can be frustrating to accept. For if something substantial or obvious jumps out on the MRI to a neurosurgeon then that patient is more likely to be offered surgery (a potential solution to the problem versus pain meds that merely mask the pain temporarily).

    My new MRI looks somewhat worse compared to the previous one (more than two years ago); nonetheless my gut tells me the new neurosurgeon is going to state surgery is not an option.

    I have 10mm central canal stenosis but this, too, is described as “mild” on the report.

    Hang in there. Good luck at your next appmt and please keep us posted.

  • Thank you guys. I will keep you posted. My main issue at this point is that I’ve changed careers a few times over the last 5 years and that means taking pay cuts and I’m low on money. Also, my newest job is a city job And I’m quite a few years short of being vested and if I need to take extended time off I’ll most likely be let go. I’ll keep you posted on the 2nd opinion and see what happens. 

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  • Update : I received my 2nd MBB Saturday afternoon. It finally kicked in Monday morning. Odd, because it’s supposed to work right away. My follow up appt is in 2 weeks. Gunna have to ask about this. 

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