Facet Joint Blocks

Once the origin of back pain is accurately diagnosed, an appropriate treatment program can begin. Facet joint blocks or medial branch nerve blocks are used to diagnose the source of back pain caused by facet joint diseases such as arthritis or injury. During the procedure, local anesthetic is administered to a particular facet joint to determine if that joint is the source of the patient's back pain.

The facet joint block is both a test and a type of treatment. A local anesthetic is injected into the facet joint or the small nerve branches going to the facet joint to numb the area around the facet joint. If the pain goes away, it can be assumed that the facet joint is contributing to the problem.

Facet joint blocks or medial branch nerve blocks are very simple and safe outpatient procedures. They are done under x-ray guidance and with light sedation.

First, a needle is inserted into the center of the facet joint or next to the small nerve branches that go to the joint. A fluoroscope, a special X-ray TV, allows the spine surgeon and the needle and ensures proper placement. Once the needle is inserted, a combination of anesthetic and cortisone is injected. Patients are generally released after 1-2 hours and usually can return to their normal work and activities the next day.

Facet joint blocks provide only temporary relief from pain, usually several weeks or a couple months. They are, however, very effective in getting an accurate diagnosis for the source of back pain in order to determine the best treatment.