In order to determine if your facet joints are responsible for your neck or back pain, we perform medial branch blocks. A medial branch block is a block that is performed under fluoroscopy (x-ray) with local anesthetic (numbing medicine) injection in your back. Following the procedure, we want you to keep a pain diary that records if you receive any pain relief, the amount of pain relief and for how long. For example: Pain was half of what it was before the procedure. The relief lasted for four hours.
Based on your response to this block we can determine if you are a candidate for medial branch radiofrequency (rhizotomy). If you have no pain relief after this procedure your provider will keep working with you to find the source of your pain and discuss other treatment options treatment choices.
In some cases, facet blocks may be performed which involves the injection of local anesthetic and/or corticosteroid into the facet joint of the spine.
A facet block is an injection of local anesthetic and steroid into a joint in the spine. A medial branch block is similar but the medication is placed outside the joint space near the nerve that supplies the joint called the medial branch.
All injections are performed under fluoroscopy (x-ray) or ultrasound-guidance or both.
What can you expect after Facet Joint Injections and Medial Branch Blocks?
Your back pain may be improved immediately after the injection from the local anesthetic. It is important to keep track of how you feel for the remainder of the day. The steroid, when used, takes two or three days to have on effect in most people and peaks in about two weeks.