Facet Joint Injection/Medial Branch Nerve Block (cervical, thoracic, lumbar)

Facet joint injections and medial branch blocks are interventional pain procedures used to diagnose and treat arthritic pain originating from the joints in the spine.  

A small needle is advanced with the help of a fluoroscopy or x-ray machine. Brief x-rays are taken to help direct the needle to the correct location. A small amount of local anesthetic and possibly steroid are slowly injected in the appropriate location.

Risks of this procedure are generally small, and most patients tolerate the procedure very well. All interventions include the risk of bleeding and infection. The entire procedure is performed using sterile technique; therefore, the risk of infection is very low. If you are taking blood thinners, our office will coordinate with your prescribing physician to limit the risk of bleeding. Some patients have some discomfort from the needle placement during the procedure. Our physicians use a local numbing medicine to help your comfort during the procedure.

Because this procedure is used to determine the cause of your pain, it is important for you to have enough pain on the day of your procedure to identify an immediate improvement. This typically corresponds to a pain level of at least four out of 10. You will be required to have a driver for your procedure. If you are taking blood thinners, our office will coordinate an appropriate date for holding this medicine. You will stay for approximately 15 – 20 minutes after your procedure.   

A follow-up appointment will be scheduled after your procedure.  If you have any questions or concerns regarding your procedure, please do not hesitate to contact your physician’s office.  

Because this procedure is used to diagnose arthritic pain, it may provide only a few hours of pain relief. This is expected and normal. If the procedure confirms pain from the arthritic joints in your spine, a rhizotomy may be recommended. This procedure can provide pain relief typically lasting from six months to longer than a year.