Facet joints are located on each level of the posterior aspect of the spine, with one located on either side. They can be found in the cervical, thoracic, and lumbar parts of the spine. The facet joints are synovial joints which have articular cartilage that covers the ends of the bones. Articular cartilage has a smooth and shiny surface that allows the ends of the bones to slide freely over one another. In addition, facet joints are surrounded by a protective sleeve of soft tissue called a capsule, and are lubricated by synovial fluid. Each joint can be a source of pain if irritated or inflamed. Each facet joint has two medial nerves that carry signals to the body. If a joint is injured, damaged or degenerative it can produce irritation of these nerves and send pain signals to the brain.

The Procedure

The Medial Branch Block procedure consists of placement of an anesthetic and anti-inflammatory (steroid) solution on the medial branch nerves of the facet joint. The purpose of this injection is to determine what facet joint or medial branch nerve is producing the pain. It is also designed to interrupt the pain signal that is being carried by the medial branch nerve. Once determined an anti-inflammatory steroid can be injected to decrease inflammation and irritation caused by the nerves, thereby reducing spinal pain. The procedure may be repeated periodically, if necessary, and is an important part of treating such conditions as chronic spine arthritis, degenerative disc disease and facet syndrome. It can be performed in the cervical, thoracic or lumbar regions. All procedures are done under fluoroscopic guidance (X-ray-guided) to ensure proper placement of the medication and may be performed in an ambulatory surgical center, fluoroscopy suite or hospital setting.

The injection takes only a few minutes but the procedure can take up to 30 minutes.