Your facet joints are the small paired joints at the back of the spine that let you bend and twist. Like any joint, they develop arthritis. When they do, they produce a deep, aching pain that tends to be worse when you extend or rotate, and worse in the morning.
Facet pain is often mistaken for disc pain, because both present as back or neck pain. These injections are how we tell the difference and treat it.
Two related procedures with different jobs
A medial branch block places local anesthetic on the small nerves that carry sensation from a specific facet joint. It is primarily diagnostic. If numbing those nerves takes your pain away, we have identified the source.
A facet joint injection places anti inflammatory medication into the joint itself. It is primarily therapeutic, aimed at calming an inflamed joint.
Which one you have depends on what we are trying to learn or accomplish. Often the answer is both, in sequence.
Why this is the gateway to longer relief
If a medial branch block confirms your pain is coming from specific facet joints, you become a candidate for radiofrequency ablation, which targets those same nerves for much longer lasting relief.
That is the value of doing this properly. A block is not just a treatment. It is the test that determines whether a longer term solution will work for you before anyone performs it.
How it is done
Both procedures are performed under image guidance, using live X-ray or ultrasound. You lie face down, the skin is numbed, and a thin needle is guided to the joint or to the nerves supplying it. The whole thing usually takes fifteen to twenty minutes.
You are awake. Most people describe pressure rather than pain.
What to expect afterward
Because these procedures are often diagnostic, what you notice in the hours afterward matters, and we will ask you to pay attention.
You may be given a simple pain diary. How much relief you get, and for how long, is clinical information that guides the next step. A block that relieves your pain for a few hours is not a failure. It is a positive result.
Soreness at the injection site for a day or two is normal.