Difference Between Epidural Steroid Injections and Medial Branch Blocks

Auto accidents frequently cause serious injuries to the spine due to the sudden transfer of force through the neck and back. Victims can experience cervical, thoracic, or lumbar pain, sometimes with radiating symptoms such as numbness, tingling, or weakness into the arms or legs. These symptoms can develop immediately or surface gradually in the days and weeks after a crash. Early medical evaluation is critical because untreated spinal injuries can become chronic and permanently alter nerve function.

Consistent, structured medical care serves two important purposes. First, it increases the likelihood of a meaningful physical recovery. Second, it creates a clear medical record that documents the severity of injuries and the necessity of treatment, which becomes essential when proving damages in a personal injury claim. If conservative care such as physical therapy, chiropractic care, and medication does not fully resolve pain, minimally invasive interventional procedures may be recommended. Two of the most common procedures are Epidural Steroid Injections (ESIs) and Medial Branch Blocks (MBB).

This article explains the difference between the two procedures, when they are appropriate, how they support both patient recovery and legal claims, and why they matter in establishing damages.

Epidural Steroid Injections

What are Epidural Steroid Injections

An epidural steroid injection involves delivering anti-inflammatory steroid medication directly into the epidural space surrounding the spinal nerves. This space often becomes inflamed when a herniated or bulging disc compresses or irritates the nerves after a traumatic injury such as a car crash.

When are Epidural Steroid Injections Appropriate

An ESI is typically recommended when imaging studies such as MRI or CT confirm disc bulges, disc herniations, or spinal stenosis that are compressing the nerves and producing radicular symptoms. These symptoms frequently include arm or leg pain, weakness, burning sensations, or numbness.

How Epidural Steroid Injections Help

Steroid medication reduces inflammation and swelling around the nerve roots. Reducing inflammation decreases the mechanical pressure on the nerve, which may reduce pain and restore function. Many patients also find they can participate in physical therapy more effectively after an injection because their pain levels are better controlled.

Expected Duration and Purpose

Relief may last for weeks or months depending on the patient’s injury. For some, a series of injections may be recommended to maximize benefit.

Risks and Complications

Risks are generally low but may include infection, temporary increase in pain, headache, or steroid-related side effects.

Cost and Evidence Value

Costs vary depending on facility and provider, but ESIs are significantly cheaper and less invasive than surgery. In legal cases, injections demonstrate that the injury is serious enough to require interventional care beyond basic therapy. This can substantially increase the value of a settlement because the medical records support the need for ongoing treatment and long-term symptoms.

Medial Branch Blocks

What are Medial Branch Blocks

A medial branch block involves injecting a numbing medication near the medial branch nerves that supply sensation to the facet joints in the spine. Unlike an epidural injection, this procedure does not treat disc injuries or nerve compression. Instead, it is used to diagnose and treat pain originating from the facet joints themselves.

Purpose as a Diagnostic Tool

The primary purpose of a medial branch block is diagnostic. If pain is relieved immediately after the block, this confirms that the facet joints are the source of pain. Relief is temporary because the injection contains anesthetic rather than steroid.

When Physicians Recommend Medial Branch Blocks

MBB procedures are typically recommended for localized neck or back pain without radiating symptoms or when imaging reveals arthritic or traumatic damage to the facet joints rather than disc pathology.

The Next Step: Radiofrequency Ablation

If the block provides relief, the patient may proceed to radiofrequency ablation. This procedure uses heat to disrupt the nerve’s ability to send pain signals to the brain. The result can provide long term relief, often lasting nine to fourteen months.

Value in Injury Litigation

When an MBB is successful and followed by radiofrequency ablation, the medical records strongly establish the level of chronic pain. This supports claims for non-economic damages such as pain and suffering and helps prove permanency.

Choosing Between ESIs and MBBs

The decision between ESIs and MBBs depends on the source of pain. Imaging studies, physical examination, and the presence of radiating symptoms guide decision making. Disc herniations with nerve compression usually require epidural injections. Facet joint pain localized to a specific spinal region is more likely treated with medial branch blocks and potentially radiofrequency ablation.

Interventional injections provide critical evidence that injuries are real, painful, and disabling. They show that conservative care alone was not sufficient and that symptoms required escalation to more advanced medical intervention. These records help justify:

• Medical expenses
• Future treatment needs
• Lost wages and reduced ability to work
• Non-economic damages such as pain, suffering, and loss of enjoyment of life
• Permanency when expected

Expert testimony is often used to explain the necessity and effectiveness of these procedures and connect them causally to the crash.

Final Thoughts

Auto injuries can cause long-term spinal dysfunction if they are not adequately treated. Epidural steroid injections and medial branch blocks provide essential relief for many patients while also functioning as important diagnostic and evidentiary tools. When treatment escalates to this level, it signals a significant injury that demands fair compensation, supported by clear medical documentation.