At Unique Pain Medicine of New York, our board certified pain management specialists are committed to helping you live pain free. We are in network to most health insurance plans and offer same day appointments.
A medial branch block is a simple office based procedure where a small dose of local anesthetic is placed next to the facet joint. This helps identify which facet joint is involved, and result in a reduction in pain, increase in function and mobility, and improved quality of life.
Medial branch blocks and facet injections are common treatment options for patients who experience back pain, neck pain and headaches. These simple injections are administered around facet joints to reduce inflammation and irritation from arthritis pain. The facet joints are located along the spine and connect each vertebra to the next. These joints help support the spine by providing stability and range of motion. They can become painful due to arthritis of the spine, a mechanical injury, or poor posture.
Typical Benefits Of Medial Branch Blocks
- Stops the pain cycle and produces fast, effective pain relief.
- Very safe procedure with minimal side effects and no down time.
- No need to take pain medications that can cause systemic side effects.
- Outpatient procedure performed in the office and only takes around 10 minutes.
- A diagnostic tool that identifies patients who are candidates for Radiofrequency Ablation of the medial branch nerve.
What Is Facet Joint Arthritis?
Patients with facet joint arthritis will typically complain of pain and stiffness in the back or neck. The pain is usually described as a dull ache around the affected area. The pain tends not to radiate into the legs or arms. The pain and stiffness is usually worse first thing in the morning and at the end of the day. The pain is exacerbated with physical activity or bending and twisting. Sometimes it can be painful to get up from a seated position.
Like other joints in the body, facet joints are covered by cartilage that allows the bones to move next to each other smoothly without friction. When these areas are inflamed, the bones rub against each other, which causes pain. Arthritis of the facet joints carries multiple names for the same condition, including facet joint arthritis, facet joint arthropathy, and spondylosis.
The Medial Branch Block Procedure
A Medial Branch Block is a simple office based procedure. It typically takes 10 minutes, and there is no downtime after. It can be done with local anesthesia, or intravenous sedation for comfort if desired. It is generally not painful and well tolerated. During a medial branch block, a small needle is inserted next to the involved facet joint with X-ray guidance (fluoroscopy). After proper placement of the needle is confirmed, a local anesthetic is injected through the needle. This will anesthetize the facet joint and block the pain pathway. This will help identify which facet joint is affected, and results in reduction of pain, increase in function and improved quality of life. Some patients may feel better right away. Patients may return to work the same day or next day.
Commonly Asked Questions About Medial Branch Block/Facet Joint Injections
What happens if medial brand block doesn’t work?
If a medial branch block does not relieve your pain, then the diagnosis of facet joint arthropathy may not be correct. This tells the physician that other structures may be the reason for your pain.
How long do medial branch block last?
Medial branch blocks are both diagnostic and therapeutic. Some patients get sustained relief from a block, while others report a few days to a few weeks of relief. If a medial branch block is successful at relieving your pain, you may be a candidate for a Radiofrequency Ablation procedure, which is heat therapy to the facet joint. Radiofrequency Ablation will provide relief for a period of 9 months to 2 years.
Is a medial branch block painful?
Medial branch blocks are generally minimally uncomfortable and very well tolerated. If you have a fear of needles or have severe pain, we do offer IV sedation which is administered by a board certified anesthesiologist. This will help you relax and make the procedure completely painless.
Are medial branch blocks the same as facet injections?
Both procedure are aimed at blocking pain originating from the facet joint. Medial branch blocks tend to be used for diagnosis purposes while facet injections can be used for therapeutic purposes. Both procedures are very similar, and the terms are often used interchangeably.
What are the side effects of a medial branch block / facet joint injection?
Side effects generally do not occur. When they do, they tend to be mild and easy to manage. Some possible side effects include temporary facial redness, tenderness at the injection site, mild sleep disturbances, menstrual changes, and elevated blood sugar in diabetics.
Are facet joint injections FDA approved?
Yes, facet injections are FDA approved for the diagnosis and treatment of arthritis mediated facet joint pain.
Are facet injections safe?
Face injections are very safe. In expert hands, complications are extremely rare.
Are Medial Branch Block/Facet Joint Injections covered by insurance?
Yes, all health insurance plans cover this procedure.
How Medial Branch Blocks Work
The medial branch block interrupts signals from the the medial branch nerve, which communicates with the facets joints. The anesthetic agent interrupts the pain signals, reduces inflammation, and stops the pain. The purpose of this procedure is to determine if the pain you are experiencing is caused by inflammation of the facet joint. If this procedure leads to a short-term relief of pain of at least 70-80%, the patient is considered an ideal candidate for Radiofrequency Ablation procedure, which would provide long-lasting pain relief.
Medial Branch Blocks for Migraine (Cervicogenic Headache)
In younger people, chronic headaches frequently occur secondary to disorders of the cervical spine. These are not true migraines, as general migraine treatments will not abort the headaches. An upper cervical facet injection can help diagnose and treat the source of the headaches. If you have been diagnosed with having chronic migraines and treatment isn’t working, it is possible that the migraine is coming from the cervical facet joints. If a facet injection breaks the pain cycle, the cause of the migraine is likely cervicogenic. Once the diagnosis is established, treatment is usually effective at greatly decreasing the duration and intensity of migraines, and improving quality of life.
What Our Patients Say About Our Services
I love this place! Staff is always friendly and Dr. Mila really knows her stuff. She's everything I could want in a Dr. If you are looking for a pain management Dr. in Brooklyn, she is definitely a great choice. My spine is a mess from a car accident and she can always pinpoint exactly where my pain is coming from and what I need. I've been seeing her for about a year now and she doesn't even begin to compare to the others I've seen who barely remember me and their offices are always packed. I always get in and out fairly quickly and she takes the time to assess what I need. It's great to find doctors like this.
I had low back pain for years and went to multiple doctors with no results. Dr. M has been treating me for almost a year, and for the first time in my life, I am pain free! She is the only one that was able to properly diagnose me and provide appropriate treatment. She is considerate, attentive and compassionate. Her office is modern and always clean. Her staff is friendly and helpful. She now treats my entire family with great results. Thank you Dr. M!
The office staff was kind and helpful with scheduling and insurance. The medical assistants, PAs, and Drs were all very kind. I never had a ton of time with any of them but didn't feel like I was missing out on it or being rushed. I ended up getting a steroid injection in the office and as someone TERRIFIED of needles and who was having mobility issues, I have to say that I was treated with great care and was comfortable throughout all of my visits.
Dr. Mogilevsky is AMAZING. I've been to 5 different doctors for pain management, and Dr. Mogilevsky is the first doctor to take my pain seriously and treat it as needed. I'm also extremely impressed with her staff. My anesthesiologist, the receptionists, and the nurses are all attentive and friendly. I finally found a doctor who I feel confident going back to.
I've been going to Unique Pain Medicine since they opened their practice on Lexington Avenue. Dr. Mogilevsky (Dr. M) is the best! I was injured back in 2001 and has progressively gotten worse throughout the years. Although I will never get better due to my injury, she is very proactive in her approach to help minimize my pain which has allowed me to have quality of life again. She always greets you with a smile and hug, and her anesthesiologist together with the rest of her staff are always very friendly and professional. And what's also very important is that you don't wait to be taken at the time of your scheduled appointment. I highly recommend Dr. M.
I have been dealing with low back problems for at least 20 years. I have had physical therapy and MRI done on my back with no results until a doctor recommended Unique pain management. From my very first appointment to all follow-up visits. I was and still is very impressed with the quality of service and care I experienced. Everything was top of the line including the office. The place was immaculate. I would recommend this place as a first choice for anyone seeking treatment for back problems or pain. The employees were very professional and patient and the wait time was good. I will always go there to continue treatment as long as I need to.
Dawn R.Google Local
Went to see Dr Mogilevsky for my plantar fasciitis problem. She by far has been the best doctor for a first experience of any physician I have had in 20 years living in NYC. My appointment was at 9am and was seen even EARLIER than that. She was fantastic. She is pleasant and very personal. She took the time to listen to what my problem was, the history and my prior treatments. She was quick to provide a remedy and did the PAINLESS procedure right in the office. The entire office staff was nice, helpful and accommodating. I would 10000% recommend this practice to anyone looking for a solution to their pain!
I was treated for sever Sciatica Pain by Dr. Mogilevsky and I couldn't be more happier with the results. I came in hopping on one foot and was driven in a horizontal position. The pain was so bad that even the prescribed ibuprofen 800 wasn't helping anymore. From the time I called for an appointment to the moment I WALKED out of the facility was a great experience. Throughout the entire time they set expectations by letting me know what will take place and all those expectations were met. Dr. Mogilevsky was terrific and made the actual procedure go smoothly. Would highly recommend this practice as pain management specialists to anyone that is searching. Thank you!!!
Everyone at Unique Pain Medicine is wonderful. The staff is friendly, professional, polite and caring, including everyone from the front desk to anesthesiology. The doctors are terrific and personable. I actually love coming here, despite my pain. The treatment I receive manages my pain, and my condition has become increasingly easier to deal with. I trust them, and believe in the treatment. I have referred several of my friends to Dr. Mogilevsky and Unique Pain Medicine. I highly recommend them. Vince S (pigseye12).
Vince S.Google Local
This place was wonderful! The facility is clean and The support staff were very friendly and patient. The health care providers took as much time needed to explain my issue so I fully understood my medical condition and the treatment options available to me. I had chronic lower back pain for an entire year, with occasional flares. After treatment, about 2 weeks ago, I've started getting my life back in order- able to work out/get fit, work with random back spasm, and just enjoyed life without the annoyance that's been bothering me over the last year. I wholeheartedly recommend this practice and would come here again for my problems.
Danny C.Google Local
AMAZING service, professional caring doctors & staff. Doctors care and want to help you get better. Doctors explain in detail every service that they provide. I am so thankful for Unique Pain Medicine i can't thank them enough for helping me with my back pain.
Desiree G.Google Local
This place is Great. The doctors are warm and courteous. They listen to you and are very informative. Their bedside manner is the best and not only do they treat you like a patient but more importantly they treat you like a person. Their staff is also very kind and gracious. But most of all they are VERY GOOD at their jobs. I appreciate them and highly recommend them if you are dealing with pain.
Ya G.Google Local
I had a great experience with this office. Not one to write reviews, but I have to say that I was impressed by the doctors and staff. They really helped me with my shoulder pain. They also had a great bedside manner. They constantly checked in with me about how I was feeling. Plus they had snacks and juice- which I very much appreciated after my procedure. Super hospitable office.
Keren S.Google Local
My experience at Unique Pain Medicine was exceptional from start to finish! The front desk staff is always friendly and helpful. The doctor accurately identified the cause of my lower back pain and discussed my condition and MRI results in great detail. Together we decided on a course of treatment that I fully understood and felt comfortable with. My back hasn't felt this great in years!
Simona M.Google Local
Everyone here I'm talking the receptionists, the medical assistants, nurses, anesthesiologists, etc...) is polite, educated, informative, and genuinely make me feel that they want what is best for my health and treating my chronic back pain. I even have an annoying insurance company and they have no problem taking the extra steps to make sure my insurance will cover their services. This is not a place where you walk in and a doctor throws pain medication at you and wishes you on your way - this is a place that takes strategic and curated steps to make sure that your individual pain is recognized, understood, and has a comprehensive plan of action. Thank you to everyone here!!!
Stephen C.Google Local
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