Facet blocks and Medial Branch Blocks
These procedures are used to diagnose and treat low back pain caused by inflamed, strained, or arthritic joints in the back and neck. The joints line the spine on both sides, lie deep to the paraspinal muscles but closer to the skin than the discs and nerves. Pain is typically local, worsened with standing or with any prolonged position, and worsened with leaning back as opposed to bending forward. Pain is not associated with any numbness or tingling in the arms or legs. Each joint is typically fed by 2 tiny nerves that transmit pain signals from the joints towards the brain.
Facet blocks: A physician, using an x-ray machine, can inject the joints with a very small amount of anesthetic and cortisone to provide pain relief that may last from several weeks to several months. These work best to treat pain following injuries or to treat flares of pain and those of chronic conditions. Chronic pain due to facet joint conditions is typically initially addressed with medial branch blocks.
Medial Branch blocks: This procedure involves the placement of local anesthetic only on the tiny nerves to the facet joints, for the purpose of diagnosing which joint(s) causes the pain. The local anesthetic lasts about 8 hours. If the patient’s pain resolves for this period of time than we have identified the source of pain, the facet joint. The patient may then be a candidate for radiofrequency ablation (AKA facet rhizotomy) procedures, to provide longer-lasting relief of pain from the facet joints.