Procedure

Medial Branch Blocks (Facet Joint Injections)

Medial branch blocks — often referred to by patients as facet joint injections — are precise diagnostic injections that confirm whether the facet joints of the spine are the source of your neck or back pain and are the essential first step before radiofrequency ablation.

Candidacy

Who This May Help

Medial branch blocks may be appropriate if you have chronic neck or back pain that is suspected to originate from the facet joints — small joints that connect the vertebrae and guide spinal movement. Facet joint pain often produces a deep, aching pain localized to the neck or lower back that worsens with extension or prolonged standing and does not typically travel below the knee. Because imaging alone cannot reliably confirm facet joint pain as the primary source, medial branch blocks are the diagnostic standard used to make that determination. A consultation with our clinical team will determine whether you are a candidate.

Procedure Overview

Each facet joint in the spine is supplied by two small nerves called medial branch nerves. A medial branch block — sometimes called a facet joint injection by patients — places a small amount of local anesthetic alongside these nerves under image guidance, temporarily numbing them. If you experience significant relief from your usual pain during the hours following the injection, it confirms that the facet joints supplied by those nerves are the primary pain generator — and that radiofrequency ablation of those nerves is likely to provide longer-term relief.

Medial branch blocks can be performed at any level of the spine — cervical for neck pain, thoracic for mid-back pain, or lumbar for lower back pain — depending on where your symptoms are located. The procedure is same-day outpatient and most patients return to normal activity the following day. Carefully tracking your pain response in the hours after the block is an important part of the diagnostic process.

Recovery & Results

What to Expect After the Procedure

Medial branch blocks are same-day outpatient procedures and most patients feel back to normal within a day. Some temporary soreness at the injection site is common and typically resolves within one to two days. The most important thing after a medial branch block is to pay close attention to your pain level throughout the day and note how much relief you experienced, how long it lasted, and when your pain returned to its usual level.

Your response to the block — documented carefully and reported back to our team — is the key diagnostic information that determines your next step. If your response confirms facet joint pain as the primary source, radiofrequency ablation will typically be recommended as the longer-term treatment option.

Frequently Asked Questions

Common Questions

A medial branch block is a diagnostic injection that temporarily numbs the medial branch nerves — the small nerves that carry pain signals from the facet joints of the spine to the brain. By blocking these nerves, we can determine whether the facet joints are the primary source of your neck or back pain. If you experience significant pain relief during the period the nerve is blocked, it confirms that the facet joints are the pain generator and helps guide the next step in your treatment plan.
Radiofrequency ablation works by permanently interrupting the medial branch nerves to provide long-term relief from facet joint pain. Before proceeding with ablation, it is essential to confirm that these nerves are actually responsible for your pain. A medial branch block does this by temporarily numbing the nerves — if your pain improves significantly during the block, it confirms the diagnosis and indicates that radiofrequency ablation is likely to be effective. Proceeding with ablation without this diagnostic step would reduce the likelihood of a successful outcome.
Most insurance plans require two separate medial branch blocks on two different occasions before approving radiofrequency ablation. This two-block requirement helps confirm the consistency of your response and reduces the likelihood of a false-positive result. Our team will coordinate the appropriate number of diagnostic blocks based on your clinical situation and insurance requirements.
After the procedure you will be asked to monitor your pain level carefully over the following hours and document your response — how much relief you experienced, how long it lasted, and whether your pain returned to its baseline level afterward. This information is essential for interpreting the diagnostic result and determining the appropriate next step. If your response confirms facet joint pain as the primary source, radiofrequency ablation will typically be recommended.
No. A facet joint injection places medication directly inside the facet joint itself. A medial branch block targets the small nerves that supply the facet joint from the outside. Medial branch blocks are the preferred diagnostic standard for confirming facet joint pain because they more accurately identify whether the nerve pathway — rather than the joint itself — is responsible for the pain, which is the pathway that radiofrequency ablation will target.

Schedule a Consultation

A consultation is the right starting point. Our clinical team will determine whether medial branch blocks are the appropriate next step for your neck or back pain.

Request an Appointment (850) 559-2355