A Medial Branch Block (aka Facet Joint Injection) is a simple office based procedure where a small dose of local anesthetic is placed next to the facet joint. This helps identify which facet joints are causing symptoms, and result in:
- Reduction in pain
- Increase in function and mobility
- Improved quality of life
Medial branch blocks and facet injections are common treatment options for patients who experience back pain, neck pain and headaches. These simple injections are administered around facet joints to reduce inflammation and irritation from arthritis pain. The facet joints are located along the spine and connect each vertebra to the next. These joints help support the spine by providing stability and range of motion. They can become painful due to arthritis of the spine, a mechanical injury, or poor posture.
At Unique Pain Medicine of New York, our board certified pain management specialists are committed to helping you live pain free. We are in network to most health insurance plans and offer same day appointments and treatments.
We offer Medial Branch Blocks/Facet Joint Injection procedures in our Manhattan and Brooklyn locations.
Typical Benefits Of Medial Branch Blocks
- Stops the pain cycle and produces fast, effective pain relief.
- Very safe procedure with minimal side effects and no down time.
- No need to take pain medications that can cause systemic side effects.
- Outpatient procedure performed in the office and only takes around 10 minutes.
- A diagnostic tool that identifies patients who are candidates for Radiofrequency Ablation of the medial branch nerve.
What Is Facet Joint Arthritis?
Patients with facet joint arthritis will typically complain of pain and stiffness in the back or neck. The pain is usually described as a dull ache around the affected area. The pain tends not to radiate into the legs or arms. The pain and stiffness is usually worse first thing in the morning and at the end of the day. The pain is exacerbated with physical activity or bending and twisting. Sometimes it can be painful to get up from a seated position.
Like other joints in the body, facet joints are covered by cartilage that allows the bones to move next to each other smoothly without friction. When these areas are inflamed, the bones rub against each other, which causes pain. Arthritis of the facet joints carries multiple names for the same condition, including facet joint arthritis, facet joint arthropathy, and spondylosis.
The Medial Branch Block Procedure
A Medial Branch Block is a simple office based procedure. It typically takes 10 minutes, and there is no downtime after. It can be done with local anesthesia, or intravenous sedation for comfort if desired. It is generally not painful and well tolerated. During a medial branch block, a small needle is inserted next to the involved facet joint with X-ray guidance (fluoroscopy). After proper placement of the needle is confirmed, a local anesthetic is injected through the needle. This will anesthetize the facet joint and block the pain pathway. This will help identify which facet joint is affected, and results in reduction of pain, increase in function and improved quality of life. Some patients may feel better right away. Patients may return to work the same day or next day.
Commonly Asked Questions About Medial Branch Block/Facet Joint Injections
What happens if medial brand block doesn’t work?
If a medial branch block does not relieve your pain, then the diagnosis of facet joint arthropathy may not be correct. This tells the physician that other structures may be the reason for your pain.
How long do medial branch block last?
Medial branch blocks are both diagnostic and therapeutic. Some patients get sustained relief from a block, while others report a few days to a few weeks of relief. If a medial branch block is successful at relieving your pain, you may be a candidate for a Radiofrequency Ablation procedure, which is heat therapy to the facet joint. Radiofrequency Ablation will provide relief for a period of 9 months to 2 years.
Is a medial branch block painful?
Medial branch blocks are generally minimally uncomfortable and very well tolerated. If you have a fear of needles or have severe pain, we do offer IV sedation which is administered by a board certified anesthesiologist. This will help you relax and make the procedure completely painless.
Are medial branch blocks the same as facet injections?
Both procedure are aimed at blocking pain originating from the facet joint. Medial branch blocks tend to be used for diagnosis purposes while facet injections can be used for therapeutic purposes. Both procedures are very similar, and the terms are often used interchangeably.
What are the side effects of a medial branch block / facet joint injection?
Side effects generally do not occur. When they do, they tend to be mild and easy to manage. Some possible side effects include temporary facial redness, tenderness at the injection site, mild sleep disturbances, menstrual changes, and elevated blood sugar in diabetics.
Are facet joint injections FDA approved?
Yes, facet injections are FDA approved for the diagnosis and treatment of arthritis mediated facet joint pain.
Are facet injections safe?
Face injections are very safe. In expert hands, complications are extremely rare.
Are Medial Branch Block/Facet Joint Injections covered by insurance?
Yes, all health insurance plans cover this procedure.
How Medial Branch Blocks Work
The medial branch block interrupts signals from the the medial branch nerve, which communicates with the facets joints. The anesthetic agent interrupts the pain signals, reduces inflammation, and stops the pain. The purpose of this procedure is to determine if the pain you are experiencing is caused by inflammation of the facet joint. If this procedure leads to a short-term relief of pain of at least 70-80%, the patient is considered an ideal candidate for Radiofrequency Ablation procedure, which would provide long-lasting pain relief.
Medial Branch Blocks for Migraine (Cervicogenic Headache)
In younger people, chronic headaches frequently occur secondary to disorders of the cervical spine. These are not true migraines, as general migraine treatments will not abort the headaches. An upper cervical facet injection can help diagnose and treat the source of the headaches. If you have been diagnosed with having chronic migraines and treatment isn’t working, it is possible that the migraine is coming from the cervical facet joints. If a facet injection breaks the pain cycle, the cause of the migraine is likely cervicogenic. Once the diagnosis is established, treatment is usually effective at greatly decreasing the duration and intensity of migraines, and improving quality of life.
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