What Are Facet Joint Injections And Medial Branch Blocks?

Lumbar facet syndrome, neck pain, back pain, and other pain related conditions can lead to facet degeneration. Patients suffering from facet degeneration are often referred for facet joint injections or medial branch blocks to help alleviate their back and neck pain. This type of pain affects approximately two-thirds of people in the United States over the course of their lifetimes, making this an extremely common condition that needs to be addressed. With such a high level of incidence, chronic spinal pain is the most common type of pain for people in the United States, and likely elsewhere. For back and neck pain, research has shown that up to 45% of all cases may be associated with the facet joints of the spine. Facet joint injections and medial branch blocks are, therefore, critical components of an effective strategy for pain management.

Facet joint injections or medial branch blocks can be used for more than just pain relief. They can also be effective diagnostic tools for identifying what is causing the neck and back pain that patients may be experiencing. When the application of local anesthetic and long-lasting steroids results in diminished pain emanating from the facet joints, it confirms the facet joint as the source of the pain, allowing for additional targeted therapies and additional long-term pain management, if necessary.

In some cases, the pain relief provided by facet joint injections and medial branch blocks is not enough to provide long-term relief. In these cases, additional therapies, such as exercise, physical therapy, acupuncture, or chiropractic care, may be required for effective pain-management. For most patients, the use of facet joint injections, medial branch blocks, or additional therapies offers non-invasive pain management of the neck and back without the need for surgery.

Acute injury or long-term stress may cause deterioration of the facet joints, ultimately leading to facet joint pain. Arthritis may lead to irritation and degradation of the facet joints, either as a result of age-related degeneration or an autoimmune disorder. In facet joint arthritis, the cartilage and synovial fluid in the joints begins to break down. These joint components are necessary for reducing friction and impact in the joint. Over time, this breakdown leads to irritation and pain in the spine. Poor posture or an abnormal curvature of the spine may also contribute to facet joint pain in the back or neck.

Anatomy Of The Facet Joints

Knowledge of facet joints is helpful in understanding how they function and how facet joint injections and medial branch blocks work. Facet joints, also known as zygapophysial joints, are the joints between the vertebrae. Facet joints are found on each side of the vertebrae in the neck and along a bony ridge of the spine in the lower back. Thin layers of cartilage separate and pr