Facet joints are the pairs of small joints located at each level of vertebrae in the spine, said joints of which are then connected to medial branch nerves. These nerves carry signals from the spine to the body, said signals of which include pain signals from the facet joints. When pain from these joints is experienced for prolonged periods with little to no relief despite extensive conservative pain management programs, medial branch blocks (cervical/lumbar) are then administered.
What Is It?
Medial branch blocks are administered to temporarily block the pain signals being carried by the affected medial branch nerves supplying the specific facet joints. When you experience the appropriate level of pain relief for a certain period, you may be a suitable candidate for a radiofrequency neurotomy. This is a type of injection procedure wherein heat lesions are created on the nerves, which will then interrupt pain signals to the brain.
The pain relief after a radiofrequency neurotomy procedure can last for 9 to 14 months, perhaps even longer depending on your case. Of course, the assumption here is that the procedure was performed by a qualified doctor in appropriate medical settings.
Who Should Consider It?
If you have suffered from debilitating cervical or lumbar pain for several weeks with little to no relief despite medications, physical therapy and home care measures, then medial branch blocks are the first steps toward taking your life back, so to speak. Your pain may stem from an illness or an injury to your vertebrae such as in chronic degenerative disc disease or a traumatic sports injury.
How Is It Done?
The injection procedure is performed using fluoroscopy (live x-ray) guidance technology to minimize the risks. The technology is used to identify the exact injection site and to deliver the medication at the exact nerves. This way, nerve injury and other forms of damage can be minimized, if not entirely avoided.
On the day of the medial branch blocks (cervical/lumbar) procedure, you will be advised to avoid performing strenuous activities including driving your car and to get plenty of sleep the night before. You are also well advised to ask for someone’s assistance in going home just to be on the safe side.
The following steps are followed for either a cervical or a lumbar medial branch block:
- The nurse starts an intravenous line where relaxation medication can be provided.
- The patient – you – will lie down on a special x-ray table where a fluoroscopy unit is already placed.
- The doctor cleans and sterilizes the injection area. He administers a local anesthetic to numb the treatment site, uses the x-ray guidance technology to identify the site for injection of the medial branch blocks solution, and then the solution is injected after confirmation.
What Should Be Done After It?
The medial branch blocks (cervical/lumbar) procedure should only take a few minutes for the actual injection but you will be required to rest for 20-30 minutes for observation. You will then be sent home with instructions for home care and for keeping a pain diary.
You should be able to experience significant pain relief in the next few days. You may experience an increase in pain when the anesthetic wears off but as the steroid kicks in, you should be pain-free soon enough.