Thoracic Medial Branch Block For Upper And Mid Back Pain

January 21, 2025

Discover How Thoracic Medial Branch Blocks Can Alleviate Chronic Pain in the Mid and Upper Back

Living with chronic mid and upper back pain can disrupt your daily life and make even simple tasks challenging. If you’ve tried medications, physical therapy, or other treatments without success, a thoracic medial branch block may offer the relief you’ve been searching for. This minimally invasive procedure targets the specific nerves responsible for transmitting pain, providing relief and helping you regain control of your life. In this blog, we’ll explain what thoracic medial branch blocks are, how they work, and why they might be right for you. 

What Is a Thoracic Medial Branch Block?

A thoracic medial branch block is a diagnostic and therapeutic procedure designed to treat pain originating from the facet joints in the thoracic spine. The facet joints connect the vertebrae and enable movement, but when inflamed or irritated, they can cause persistent pain in the mid and upper back. 


This procedure involves injecting a local anesthetic, sometimes combined with a corticosteroid, near the medial branch nerves. These nerves transmit pain signals from the facet joints to the brain. By blocking these signals, the injection provides immediate pain relief and confirms the source of the discomfort. 

What Is a Thoracic Medial Branch Block?

A thoracic medial branch block is a diagnostic and therapeutic procedure designed to treat pain originating from the facet joints in the thoracic spine. The facet joints connect the vertebrae and enable movement, but when inflamed or irritated, they can cause persistent pain in the mid and upper back. 


This procedure involves injecting a local anesthetic, sometimes combined with a corticosteroid, near the medial branch nerves. These nerves transmit pain signals from the facet joints to the brain. By blocking these signals, the injection provides immediate pain relief and confirms the source of the discomfort. 

How Does a Thoracic Medial Branch Block Work?

Here’s a step-by-step breakdown of the procedure: 


1. Preparation: 

  • You’ll lie on an exam table, typically on your stomach. The skin around the injection site is cleaned and sterilized to prevent infection. 
  • A local anesthetic is applied to numb the skin, minimizing discomfort during the procedure. 


2. Imaging Guidance: 

  • Using fluoroscopy (a live X-ray), the doctor carefully guides a thin needle to the medial branch nerve near the facet joint. This ensures precision and accurate placement. 


3. Injection of Medication: 

  • Once the needle is in place, the doctor injects a small amount of local anesthetic and, in some cases, a corticosteroid. The anesthetic provides immediate pain relief, while the corticosteroid reduces inflammation for longer-lasting results. 


4. Post-Procedure Monitoring: 

  • After the injection, you’ll be monitored briefly to ensure there are no immediate side effects. Most patients can leave the clinic shortly after the procedure. 

Benefits of Thoracic Medial Branch Blocks

Thoracic medial branch blocks offer several key benefits: 


  • Precise Pain Relief: The procedure targets the specific nerves causing pain, providing focused relief. 
  • Diagnostic Value: By temporarily relieving pain, the block helps confirm that the facet joints are the source of your discomfort. 
  • Quick and Minimally Invasive: The procedure is completed in about 30 minutes, with minimal downtime. 
  • Reduced Inflammation: The corticosteroid reduces inflammation in the facet joints, leading to longer-lasting relief. 

Who Can Benefit from a Thoracic Medial Branch Block?

This treatment is ideal for individuals with chronic mid and upper back pain caused by: 


  • Facet Joint Arthritis: Degeneration of the facet joints due to aging or arthritis can lead to chronic inflammation and pain. 
  • Previous Injuries or Trauma: Trauma to the thoracic spine can irritate the medial branch nerves, resulting in ongoing discomfort. 
  • Thoracic Degenerative Disc Disease: Wear and tear on the spinal discs can place extra stress on the facet joints, causing pain. 
  • Scoliosis or Kyphosis: Abnormal curvature of the spine can lead to facet joint irritation. 


If you’ve tried other treatments, such as physical therapy or medications, without finding relief, a thoracic medial branch block could be the next step in your pain management journey. 

Who Can Benefit from a Thoracic Medial Branch Block?

This treatment is ideal for individuals with chronic mid and upper back pain caused by: 


  • Facet Joint Arthritis: Degeneration of the facet joints due to aging or arthritis can lead to chronic inflammation and pain. 
  • Previous Injuries or Trauma: Trauma to the thoracic spine can irritate the medial branch nerves, resulting in ongoing discomfort. 
  • Thoracic Degenerative Disc Disease: Wear and tear on the spinal discs can place extra stress on the facet joints, causing pain. 
  • Scoliosis or Kyphosis: Abnormal curvature of the spine can lead to facet joint irritation. 


If you’ve tried other treatments, such as physical therapy or medications, without finding relief, a thoracic medial branch block could be the next step in your pain management journey. 

What to Expect After the Procedure

After the injection, many patients experience immediate pain relief due to the local anesthetic. The effects of the corticosteroid, if used, may take a few days to fully develop. Pain relief can last anywhere from a few weeks to several months, depending on the severity of your condition and your body’s response to the treatment. 


You may feel some mild soreness at the injection site, but this usually resolves within a day or two. Most patients can return to light activities the same day and resume their regular routines shortly thereafter. 


Are There Risks or Side Effects?

Thoracic medial branch blocks are generally safe, but as with any procedure, there are some potential risks and side effects: 


  • Temporary Pain or Soreness at the Injection Site: This is common and typically subsides within a few days. 
  • Temporary Numbness or Weakness: Some patients may experience numbness or weakness near the treated area, but this is usually short-lived. 
  • Infection or Bleeding: Although rare, there’s a slight risk of infection or bleeding at the injection site. 
  • Allergic Reaction: Rarely, patients may have an allergic reaction to the anesthetic or corticosteroid. 



Your doctor will discuss these risks with you and take every precaution to ensure the procedure is safe and comfortable. 

How Effective Are Thoracic Medial Branch Blocks?

Thoracic medial branch blocks are highly effective in managing pain caused by facet joint issues. According to studies published in Pain Medicine Journal, many patients experience significant pain relief and improved mobility following the procedure. For individuals who respond well, the block can serve as a precursor to radiofrequency ablation (RFA), which provides even longer-lasting relief by disabling the targeted nerves. 

At Arizona Pain Solutions, we understand how chronic mid and upper back pain can limit your life. Our experienced providers are here to offer advanced treatments like thoracic medial branch blocks, tailored to your specific needs. We’ll guide you every step of the way to ensure you feel confident and supported in your pain management journey. 


If you’re ready to explore thoracic medial branch blocks as a treatment option, contact Arizona Pain Solutions today to schedule a consultation. Our team is here to answer your questions and create a personalized plan to help you regain comfort and mobility. Share your experience or leave a question in the comments below! 


This blog has been thoroughly reviewed and edited to ensure clarity, accuracy, and professionalism, reflecting our commitment to delivering reliable and high-quality information.