Patient education
MEDIAL BRANCH BLOCK INJECTION
Also known as a "facet block"
What are medial branch blocks?
- This is a quick procedure that helps your doctor diagnose the cause of your pain in your neck or your lower back.
- This procedure typically takes 3-5 minutes.
- Your doctor places a few drops of numbing medication (usually bupivacaine) next to nerves that transmit pain sensation to facet joints in your spine. Usually, no steroid medications are used. This procedure uses “acupuncture” sized needles, and it is typically performed without sedation.
- If you can bend your neck / back and move with less pain, then the pain is likely originating from facet joints in your spine.
- This is a diagnostic procedure. Pain relief from this procedure is temporary (3-5 hours). Your pain will return once the numbing medication wears off.
- If you have pain relief, you may be a candidate for a procedure called radiofrequency ablation (RFA), which can provide up to 24 months of pain relief.
Facet joints are “deep” joints. The brain has a difficult time processing and pinpointing the exact location of pain. Neck facet arthritis can cause headaches, pain in the back of head, shoulders, and shoulder blades. Low back facet joint pain can appear to be in the buttock and back of the thighs.
It is common for people with neck facet joint pain to have intense headaches and migraines.
Pinched nerves, spinal stenosis, herniated discs, muscle spasm, shoulder joint pain, hip joint pain, and sacroiliac joint pain can appear in a similar pain pattern as facet joint pain.
One of the most reliable ways to establish whether facet joints are the cause of pain is by performing diagnostic medial branch blocks with small amounts of numbing medications.
“Medial branch” is the name of the nerves that supply pain sensation to facet joints. If these nerves are blocked or “turned off”, then pain cannot be transmitted from the corresponding joints. This results in improved spine movement and reduction in pain.
As a result of osteoarthritis (“wear and tear arthritis”), the joint surface and cartilage can become damaged over time.
This condition also affects joints “above and below” areas of spine surgery. This occurs because facet joints at fused levels (from spine surgery) can no longer contribute to spine movement. As a result, facet joints “above and below” areas of spine surgery must compensate with additional movement. This results in additional “wear and tear” and degeneration at these joints.