Overview
Facet joint injections place numbing medicine, sometimes with a steroid, into or near the small facet joints of the spine. A related test, the medial branch block, numbs the small nerves that carry pain from those joints.
GSMC is led by Dr. Dharam Mann, who completed fellowships in pain management, cardiac anesthesia and critical care at Massachusetts General Hospital/Harvard.
These injections are used both to confirm whether the facet joints are causing your pain and, in some cases, to treat it. If a medial branch block helps, radiofrequency ablation may be considered for longer relief.
How it works
Using X-ray guidance, the physician places a thin needle at the target facet joint or medial branch nerve and injects a small amount of medication. Relief that follows a diagnostic block suggests the facet joints are a pain source.
Who it may be for
- Neck or low back pain thought to come from the facet joints
- Pain worse with twisting or leaning back
- Candidates being evaluated for radiofrequency ablation
Your exam and imaging decide whether this treatment is appropriate for you.
What to expect
- Before: we review your medications (especially blood thinners), allergies and imaging. You may need a driver.
- During: you lie on a procedure table, the skin is cleaned and numbed, and the physician uses X-ray (fluoroscopy) or ultrasound guidance to place the needle.
- After: you are monitored briefly and usually go home the same day. Keep a pain diary so we can judge the response.
Recovery
You may notice relief within minutes from the numbing medicine. Record your pain levels over the next several hours as instructed. Your instructions may differ.
Risks and side effects
Every procedure has risks. Your physician will review them with you, including:
- Temporary soreness at the injection site
- Temporary increase in pain
- Bleeding or bruising
- Infection (uncommon)
- Allergic reaction (rare)
- Temporary rise in blood sugar if a steroid is used
Insurance and cost
Many plans, including Medicare, may cover this treatment when criteria are met. We verify benefits before scheduling. See accepted insurance.
Frequently asked questions
What is the difference between a facet injection and a medial branch block?
A facet injection treats the joint directly. A medial branch block numbs the nerves to the joint and is mainly used as a test before radiofrequency ablation.
Why do I need to track my pain afterward?
The pattern of relief helps confirm whether the facet joints are the source of pain and guides the next step.
Will I need two blocks?
Some insurance plans and guidelines call for two diagnostic blocks before radiofrequency ablation.
This page is general patient education and does not replace advice from your own clinician. Individual results vary.