Facet Injections/ Medial Branch Blocks

What are facet joints?

Facet joints link your vertebrae together and give your spine stability. They allow your spine to move safely while preventing it from twisting or extending too far. They also stop the vertebrae from moving out of position.

Facet joints sit inside a capsule of synovial membrane tissue and have numerous ligaments connecting them. Medial branch nerves exit your spinal cord through the gaps between your vertebrae and the facet joints, extending over the joint capsule.

Medial branch nerves transmit pain signals from your facet joints to your brain.

What are facet joint injections and medial branch blocks?

Facet joint injections and medial branch blocks are both spinal injections used in the treatment of chronic neck and back pain.

The joint capsule surrounding each facet joint has an abundant nerve supply. Also, the upper pad of the capsule connects with the sheath containing the spinal nerve.

Facet joint injections can lower pain in the joint capsule by stopping your body from producing the chemicals that cause inflammation. The injections also reduce the sensitivity of pain receptors, so the nerves send back fewer pain signals to your brain.

Medial branch blocks affect the nerves on the outside of the facet joints. They block the activity of C fibers within the nerves and limit the nerve fibers’ ability to send pain and inflammation into the joint. These actions stop the nerves from transmitting pain signals.

Dr. Shah uses facet joint injections and medial branch blocks to diagnose and treat pain that originates in the facet joints. Diagnostic injections contain a local anesthetic, while injections designed to treat facet joint pain also contain anti-inflammatory steroid medication.

Why would I need facet injections/medial branch blocks?

You might need facet joint injections/medial branch blocks if you have chronic back pain that doesn’t respond to conservative treatments like physical therapy and other medication. Conditions that are most likely to benefit from facet joint injections/medial branch blocks include:

• Facet joint syndrome
• Inflammation/Fluid within the facet joints
• Spinal stenosis
• Cervical or Lumbar Radiculopathy
• Post-whiplash pain
• Spondylosis
• Post-surgical pain (after neck or back surgery)
• Facet Joint Cysts
• Neck pain with associated headaches

Chronic pain where X-rays and other diagnostic tests don’t reveal any cause could also be suitable for facet joint injections/medial branch blocks.

What happens when I get a facet injection/medial branch block?

Having a facet injection or medial branch block is a quick outpatient procedure. Dr. Shah gives you a local anesthetic to numb the injection site, then inserts the treatment needle to deliver the medication.

Dr. Shah uses fluoroscopy or ultrasound guidance technologies that show him a moving image of the structures in your back to provide you with a targetted procedure. He may also use a contrast dye to make the images even clearer. Using these images, Dr. Shah can ensure the needle is in the correct position before delivering the injection.

It is common for Dr. Shah to use facet injections/medial branch blocks as a diagnostic procedure to assess your candidacy for radiofrequency ablation or rhizotomy of your facet joints.  This may help to provide long-term relief of your neck or back pain. 

Find out how facet injections or medial branch blocks could help relieve your pain by calling SamWell Institute for Pain Management today or booking an appointment online.