Lumbar & Cervical Facet Joint/Medial Branch Block Injections

Facet joints are small joints located between each set of vertebrae in the spine from the neck to the tailbone. The facet joints can become painful due to arthritis of the spine, a back injury, or mechanical stress to the back. There are basically two reasons for having a facet joint injection:

  • Diagnosis – to determine the source of pain
  • Therapy – to treat an abnormality that has been detected

Facet injections are used to reduce the inflammation and swelling of tissue in and around the facet joint space. A cervical facet joint injection is into one of the facet joints at the top of the spine or neck. A lumbar facet joint injection is into a facet joint in the lower back or lumbar region of the spine. To determine if the facet joint is truly the source of pain, an injection (sometimes called “block”) may be performed. If the pain is reduced after an anesthetic or numbing medication is injected into the facet joint, than it may be concluded that the facet joint is the source of pain. In addition, a facet joint injection of a corticosteroid or steroid may be injected to provide longer term relief of the pain.

Facet injections may be medial branch blocks, where the medication is injected onto the nerve rather than the joint. A medial branch block injection is a procedure in which an anesthetic is injected near small medial nerves connected to a specific facet joint. This procedure is primarily diagnostic in that if a patient has an appropriate duration of pain relief from this procedure, then they may be a candidate for a subsequent procedure called medial branch radiofrequency neurotomy for longer term pain relief.

These procedures are performed while you are awake using a local anesthetic. Multiple injections may be performed depending upon how many joints are involved. The actual injections take only about 10-20 minutes.