Facet Joint & Medial Branch Diagnostic Nerve Blocks
Serving the North Central Arkansas & South Central Missouri Communities
Located on the outside of the spinal columns, there are facet joints. These
synovial joints allow us to have full motion of our spinal column. Out
spinal movements would be extremely limited and stiff without them. Unfortunately,
facet joints can frequently get injured or become inflamed by injuries
sustained in whiplash, spinal degeneration, spinal arthritis, or surgery
on the spine. These joints are found in the neck, mid-back, and lower
back. Facet joints are interconnected to one another by medial branch
nerves. These nerves transmit pain signals to the central nervous system
from the injured facet joints. It is not possible to locate the source
of discomfort by utilizing CT scans, MRIs, or physical exams. Oftentimes,
a diagnostic nerve block is necessary. The diagnostic nerve block is a
procedure whereby the injured facet joint is numbed to lessen the pain.
This procedure should take away a majority of the pain from the injured
facet joints. The lasting effects of the diagnostic nerve blocks vary
from person to person, ranging anywhere from a few hours to a couple weeks.
The effects will eventually wear off and the pain level may rise again
to pre-injection levels.
Several medical conditions commonly treated by medial branch nerve blocks are:
- Spondylosis: Degenerated facets joints caused by osteoarthritis
- Cervicalgia: Pain in the neck area
- Lumbago: Pain in the lower back area
- Scoliosis: Spine is abnormally curved
- Failed back surgery syndrome: Pain felt even after surgery was conducted
on the spine
On the day of your scheduled procedure, please arrive at least 20 minutes
early. Our highly trained nurses will begin an IV if you want to be sedated,
and then conduct a nurse pre-operation assessment. You will be directed
to lie down on a hospital bed in the procedure room. Once you are situated
in the bed, you will be sedated and given nitrous oxide gas to induce
comfort. We will place a cold cleaning solution on your skin to lessen
the chance of infection. Then, using x-ray guidance, our doctor will identify
the site of the procedure. Once we identify the site, we will place a
small needle into the site of the medial branch nerve, still using x-ray
guidance. There are usually a total of four needles placed into each side.
We will confirm proper needle placement by utilizing dye to visually observe
its effects. The medial branch nerves become less inflamed and are numbed
by a combination of bupivacaine and steroids. The procedure is often repeated
on both sides, if it is painful there too. Finally, we will remove the
needles and direct you to a room for recovery.
What You Should Expect Afterwards
The combination of steroids and bupivacaine should start working within
just a few hours. Since you have just been given an injection, it is normal
to feel slight pain or soreness at the site of the injection. Fortunately,
you should feel that a vast majority of the pain has lessened or even
disappeared. These diagnostic injection’s effects will be felt from
two hours up to a couple weeks.
Medial branch injections have been perfected over the past several decades
and they are generally considered a safe and effective way to treat chronic
pain in facet joints. Medical complications with the procedure are very
rare, but the procedure could lead to allergic reactions, bleeding, damage
of the nerves, infection, paralysis, and even death.
If you significantly benefit from two medial nerve block procedures, you
will become a candidate for a longer-lasting pain relief procedure. This
procedure is called a medial branch rhizotomy and its effects can last
anywhere from six months all the up to two years.
For more information regarding this procedure, please call Interventional
Pain Management, a department of BRMC, at (870) 508-5900.