Facet Joint Injections

The facet joints link the vertebrae together and give them the flexibility to move against each other. There are two facet joints between each pair of vertebrae, one on each side. They extend and overlap each other to form a joint between the neighboring vertebra facet joint. The facet joints enable bending and twisting movements of the spine.

What is a medial branch nerve?

The medial branch is the branch of the spinal nerve that carries sensation and pain signals from the facet joint back to the spinal cord.


What conditions does it treat?

The facet joints are just like any other joint in the body, they are susceptible to acute injury (sprain or strain) as well as degenerative arthritis. In the neck, the facet joints may cause neck pain, shoulder pain, and headaches. The pain is especially bad when trying to look up or turn your head. In the back, the facet joints may cause lower back pain and hip pain. This pain is increased when leaning backwards or twisting.

How do facet joint injections work to control my pain?

These injections are performed as a diagnostic test when it is thought that a facet joint or joints is part of the process that is causing the pain. A small amount of a local anesthetic is injected into the joint or over the medial branch nerve to see if this will temporarily relieve your neck or back pain.


What should I expect during the procedure?

A local anesthetic will then be injected into your skin to make it numb. A needle will be inserted through the numbed skin and slowly advanced into the facet joint (or close to the medial branch nerve) using fluoroscopy (live X-rays) to guide the needle. When the needle enters the facet joint (or close to the medial branch nerve), it is common to feel a slight increase in your pain level. The local anesthetic (with or without steroid) will then be injected. Once the injection is complete, the needle will be withdrawn and a dressing will be placed over the injection site.


What can I expect after the procedure?

Facet joint injections or medial branch blocks are performed to diagnose pain being caused by the facet joints in your neck and will not relieve pain caused by intervertebral discs, spinal nerves, or muscles, which can continue to cause pain after the procedure. If your pain is not reduced within the first 24 hours after the procedure, the facet joints have been ruled out as the source of your pain. If the injections successfully treat your pain, then you will likely be scheduled for radiofrequency ablation (RFA) of the medial branch nerves.