Facet/Medial Branch Injections

Medial branch nerves are the very small nerve branches that communicate pain caused by the facet joints in the spine. These nerves do not control any muscles or sensation in the arms or legs. They are located along a bony groove in the low back and neck and over a bone in the mid back.

If facet & medial branch injections have been scheduled, there is strong evidence to suspect that the facet joints are the source of your pain. Therefore, benefit may be obtained from having these medial branch nerves blocked with an anesthetic to see if a more permanent way of blocking these nerves would provide pain relief long term.

How do Facet & Medial Branch Injections Work?

Blocking these medial branch nerves temporarily stops the transmission of pain signals from the joints to the brain. An IV may be started, to provide relaxation medication. You will be placed on the X-ray table and positioned in such a way that the physician can best visualize the bony areas where the medial branch nerves pass, using X-ray guidance. The skin is scrubbed with a cleaning solution.

Next, the physician numbs a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a very small needle, using X-ray guidance near the specific nerve being tested. A small amount of contrast (dye) may be injected to ensure proper needle position. Then, a small mixture of anesthetic medicine and anti-inflammatory steroid is injected. The injection may be repeated at several levels and on both sides of the spine.

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