How it works
How facet and medial branch blocks work
Facet joints sit between and behind the bones of the spine and help you bend and twist. When these joints are irritated or damaged, they can cause pain, often when you bend or rotate your spine.
A medial branch block places numbing medicine near the medial branch nerves, the small nerves that connect to the facet joints. If your pain eases a lot after the injection, that is a sign the facet joint is likely a source of your pain. A facet joint injection is similar, but the medicine is placed in or near the joint itself, and it includes a steroid.
At Lewis Pain & Physical Medicine, facet and medial branch blocks are used to help diagnose and plan treatment for spine joint pain. Because the main goal is to learn where your pain comes from, a block is mainly a diagnostic test. Depending on how severe your pain is, some steroid may also be used to help with pain.
Who may benefit
Who may be a candidate for a facet or medial branch block
Facet and medial branch blocks may be used for neck or back pain that gets worse when you bend or twist.
You may be a candidate if you have back or neck pain, especially pain that gets worse when you bend or twist, and your provider suspects the facet joints. A block may be recommended as a first test. If it helps, other treatments may be suggested. The team will talk with you about whether a block is right for you.
What to expect
What to expect before, during and after a block
Before your block
Your provider reviews your history and explains the plan. Tell the team about your medicines and allergies, and ask how to prepare.
During the procedure
The block is an outpatient procedure done with local numbing medicine. X-ray guidance (fluoroscopy) is used to guide a small needle to the correct spot. When it is over the medial branch nerve, the numbing medicine is injected. Several nerves can be treated in one visit. You may feel a brief sting when the numbing medicine goes in.
After your block
You may be watched for a while before you leave. You may be asked to do certain movements and record your pain levels so your provider can see how well the block worked. This record helps decide the next step. A follow-up visit is planned to talk about your options.
Benefits and limitations
What a block’s results may show
How long the relief lasts varies. For some people, it lasts only a few hours; for others it may last several weeks or longer. How long relief lasts is part of the test. It helps your provider decide what to do next.
A block can be a step before other treatment, such as radiofrequency ablation or rhizotomy. A good response can also help decide whether rhizotomy may be a next step.
Risks and side effects
Risks and side effects of facet and medial branch blocks
Risks are generally low. They can include soreness where the needle went in, an allergic reaction to the medicine and a small risk of infection.
Please talk with your provider about the risks that apply to you before you decide.
Common questions
Questions about facet and medial branch blocks
Your provider can talk through your own plan at your visit.
What is a facet and medial branch block and how does it work?
A medial branch block places numbing medicine near the small nerves that go to the facet joints of the spine. If your pain drops a lot afterward, the facet joint is likely a source of your pain. It is mainly used as a diagnostic test.
Who may be a candidate for a facet or medial branch block?
People with neck or back pain that gets worse with bending or twisting may be candidates. A block may be used to check whether the facet joints are the source of the pain. Your provider can tell you whether it suits you.
How long does the procedure take, and is it painful?
Facet and medial branch blocks are minimally invasive and are generally well tolerated. You may feel a brief stinging when the numbing medicine goes in. Several nerves can be treated in one visit, and your team can tell you how long to plan for.
What is recovery like, and when can I drive or go back to work?
You may be watched for a while afterward and asked to record your pain levels. Pain relief is usually felt within hours, though this varies. Your team will tell you when you can drive and return to work, and a follow-up visit is planned.
How long might the effect last?
The effect may last a few hours for some people and several weeks or longer for others. How long it lasts helps your provider decide on further treatment.
Clinical references
Individual results are not guaranteed and may vary from person to person. This page shares general information. It is not medical advice and does not replace a visit with a qualified clinician.