Cervical Medial Branch Block

WHAT ARE CERVICAL FACET JOINTS?

Facet joints are found on both sides of the spine. Each is about the size of a thumbnail. Cervical facet joints are named for the vertebrae they connect and the side of the spine where they are found. The right C2-3 facet joint, for example, joins the 2nd and 3rd vertebrae on the right side. Facet joints not only connect the vertebrae, but they also guide the spine during movement. Medial branch nerves, located near facet joints, transmit pain signals from the facet joints to your brain.

WHAT IS CERVICAL FACET JOINT PAIN?

Cervical facet joint pain is a result of injury, either to cartilage inside the joint or to connecting ligaments  surrounding it. Pain from an injured cervical facet joint may feel like muscle tension or it can be severe pain. Depending  on which facet joint is affected, the pain may occur in an area from your head down to your shoulder blade. The diagram shows areas of pain usually associated with specific joints.

HOW DO I KNOW IF I HAVE CERVICAL FACET PAIN?

If you have pain in one or more of these areas, and it lasts longer than two months, you may have cervical  facet pain. Common tests such as x-rays or MRIs may not always show if a facet joint is the reason for your pain.

WHAT IS A CERVICAL MEDIAL BRANCH BLOCK?

During this procedure, a local anesthetic (numbing medicine) is injected near the medial branch nerve. This stops the transmission of pain signals from the facet joint. If your pain is reduced and you are able to move your neck normally, then the doctor will know which facet joint has been causing your pain.

WHAT HAPPENS DURING AN INJECTION?

The injection may start with an IV (medicine given intravenously) to help you relax. A local anesthetic may be used to numb your skin. The doctor will then insert a thin needle near the medial branch nerve. Fluoroscopy, a type of x-ray, will be  used to ensure the safe and proper position of the needle. A dye will also be injected to make sure the  needle is in the correct spot. Once your physician is sure the needle is correctly placed, the medicine will be injected.

WHAT HAPPENS AFTER AN INJECTION?

You will be monitored for up to 30 minutes after the injection. Before you leave, the clinic will give you discharge instructions as well as a pain diary. Keeping track of your pain helps the doctor know what the next step will be. You may want to check for pain by moving your neck in ways that hurt before the injection, but do not overdo it. You may feel immediate pain relief and numbness in your neck and upper back for a  brief period of time after the injection. This means the medication has reached the right spot. You should be able to return to work the day after the injection, but always check with your doctor.

HOW LONG CAN I EXPECT PAIN RELIEF?

How long you can expect pain relief depends on how many areas are injured, and on the amount of  inflammation. If your pain goes away for a short time, but then returns, you may be a candidate for radiofrequency  ablation (RFA) to the medial branch nerve. This procedure provides a more permanent disruption of pain signals.

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