Facet Joint Injection/Medial Branch Block
The facet joints, are common sources of pain, either from degenerative arthritic conditions or from acute injury. The pain typically occurs with twisting or backward movements of the spine. In the neck, facet joint pathology may be associated with headaches, shoulder pain or upper back pain and, in the lower back, these joints may cause back, buttock or thigh pain. These joints are located in the posterior area of the spine and are accessed for injection with the use of X-ray imaging. Two injection techniques are used to treat facet joint-related pain and each is described below.
Facet joint injection
The joint itself can be penetrated with a needle and a small amount of contrast is injected, confirming correct needle placement. Facet joint cysts may develop as part of spinal pathology and cause back pain and sometimes radicular pain if the cyst is pressing on nerve structures. This technique is used to drain/lyse the cyst. A combination of local anesthetic and steroid is typically injected to relieve the pain. The effect of the local anesthetic may confirm the joint as a source of pain and the steroid may act to decrease inflammation for long-term relief. In some cases, after the cyst is drained, it may resolve your symptoms and can be curative or the injected steroid may provide excellent long-term results.
Medial Branch Block (MBB)
Two small nerves supply each facet joint. These are blocked with a very small amount of local anesthetic (Novocaine-like substance), effectively decreasing the ability of the joint to generate sensations of pain. This injection is diagnostic and can be therapeutic also. This technique is used to treat headaches, neck pain and mid/low back pain. If the effects of the MBB are short lived a Radiofrequency Ablation might be necessary.
