A facet joint block is the injection of a local anesthetic and steroids in the facet joint on the side of the spinal column, not
around the spinal cord. Alternatively, a small amount of a local anesthetic can beis placed on a small nerve that goes to
(innervate) the facet joint as well as the small ligaments around the joint. This is called a Medial Branch Nerve Block (MBB), or
Facet Joint Nerve Block (FNB).
A set of MBB’s may be performed if it is suspected that the neck or back pain may be originating from the small facet joints of
the spinal column. These blocks are for diagnosis only, and not for long lasting relief. If the MBB’s are successful in temporarily
alleviating a large percentage of the pain, we may perform a more definitive procedure, radiofrequency ablation.
Radiofrequency ablations involve using a special needle connected to a machine to "burn" (damage) the tiny pain fibers that go
to the joints in order to block the pain sensations originating from them. There would not be a motor or sensory deficit due to
the procedure. This procedure can achieve long lasting relief.
The patient will be placed face down (prone) on a fluoroscopy table. The area will be cleansed with an antiseptic and then
numbed. The doctor will use X-ray to help guide placement of needles on the nerves near the facet joints, Then, a small
amounts of local anesthetic will be injected. The procedure will take 30-45 minutes. Band-Aids will be placed at the injection
sites, and a nurse will monitor the blood pressure and pulse and will review the discharge instructions with the patient before
going home. The patient will be examined after the procedure to evaluate any increase in the range of motion or decrease of
pain score. The patient is also asked to keep track of the pain over the following several hours. This will help us determine if
the facet joints are involved with the pain syndrome.
