Cervical Facet Medial Branch Block
WHAT ARE CERVICAL FACET JOINTS?
Facet joints are found on both sides of the spine. Each is about the size of a thumbnail. Cervical facet joints are named for the vertebrae they connect and the side of the spine where they are found. The right C2-3 facet joint, for example, joins the 2nd and 3rd vertebrae on the right side. Facet joints not only connect the vertebrae, but they also guide the spine during movement.
WHAT IS CERVICAL FACET JOINT PAIN?
Cervical facet joint pain is a result of injury, either to the cartilage inside the joint or the connecting ligaments surrounding the joint.
Pain from an injured cervical facet joint may range from muscle tension to more severe pain. Depending on which facet joint is affected, the pain may occur in an area from your head down to your shoulder blade. The diagram shows areas of pain usually associated with specific joints.
HOW DO I KNOW IF I HAVE CERVICAL FACET PAIN?
If you have pain in one or more of these areas when you turn your head, and it has lasted longer than two months, you may have cervical facet pain. Common tests such as x-rays or MRIs may not always show if a facet joint is causing your pain.
WHAT IS A CERVICAL FACET INJECTION?
During this procedure, a local anesthetic (numbing medicine) and a corticosteroid (anti- inflammatory medicine) are injected into one or more cervical facet joints.
The injection can be used to diagnose or treat. If the injection temporarily lessens your pain and helps you move better, your doctor will know which facet joint is causing the pain. The corticosteroid is used to treat inflammation of the facet joint.
WHAT HAPPENS DURING AN INJECTION?
The injection may start with an IV (medicine given intravenously) to help you relax. A local anesthetic may be used to numb your skin.
The doctor will then insert a thin needle directly into the facet joint. Fluoroscopy, a type of x-ray, may be used to ensure the safe and proper position of the needle. A dye may also be injected to make sure the needle is in the correct spot.
Once your physician is sure the needle is correctly placed, the medicine will be injected.
WHAT HAPPENS AFTER AN INJECTION?
You will be monitored for up to 30 minutes after the injection. Before you leave, the clinic will give you discharge instructions as well as a pain diary. Keeping track of your pain helps the doctor know what the next step will be.
You may want to check for pain by moving your neck in ways that hurt before the injection, but do not overdo it. You may feel immediate pain relief and numbness in your neck and arm for up to six hours after the injection. This means the medication has reached the right spot.
Your pain may return after this short pain-free period, or may even be a little worse for a day or two. This is normal. It may be caused by needle irritation or by the steroid itself. Steroids usually take two or three days to start working, but can take as long as a week.
You should be able to return to work the day after the injection, but always check with your doctor.
HOW LONG CAN I EXPECT PAIN RELIEF?
Depending on the number of injured areas and the amount of inflammation, an injection could offer several months of pain relief before further treatment is needed. If there is no underlying bone or joint problem, one injection could bring long-term pain relief. If your pain is caused by injury to more than one area, only some of your symptoms may be helped by one injection.