Spinal Facet Injections in NYC

A spinal facet joint injection is a shot of a medication consisting of a numbing agent and a steroid into one or more of the small joints, called facet joints, situated between each bone of the spine on either side of your back.

A spinal facet joint block serves two purposes: therapeutic and diagnostic. The injection is given into your neck or back to relieve inflammation and pain caused by the facet joint(s) in that area. If the injection relieves pain, it also helps pinpoint that the facet joint is the source of pain.

A medial branch block involves injecting the numbing medication into the nerves called medial branches that spread out to the spine’s facet joints. These nerves carry pain signals from these joints to your brain. Unlike a spinal facet injection that goes directly into your facet joint, a medial branch block goes into the space around facet joints.

Yes, medial branch block and spinal facet injections are done under X-ray guidance, making the injections much safer and more accurate.

No, the medial branch block is a very safe procedure. Especially when performed by a qualified pain specialist who is an expert with these types of spine procedures.

When the numbing medication wears off, you may experience discomfort at the points where the needles were placed. If you do have discomfort, you can simply ice the sore area.

You may feel transient discomfort at the injection site. If the injection spills into nearby nerves, there will be temporary weakness and numbness. There’s also a slight risk of infection at the injection site. However, this is very rare.

To perform a spinal facet injection, you’ll be asked to lie on a table with your face down. After thoroughly cleansing the skin over the area to be treated, it is numbed with a local anesthetic. We then use X-ray guidance, called fluoroscopy, to guide a small needle into your facet joint. Once the needle is in the correct position, a small amount of liquid dye is injected. This liquid dye shows up on the x-ray image, allowing us to view where it flows. If it flows into the correct site, the medication is injected following the same route, ensuring that it reaches exactly where it is intended. The needle is then finally removed.

For medial branch blocks, the entire procedure is the same except that the needle is inserted into the space around your facet joints to block the nerves supplying them. If this procedure provides pain relief (which is temporary), you will be offered the radiofrequency ablation of the medial branch nerves.

All insurance would cover the medial branch block or spinal facet injections. Especially if conservative treatments (like medications and physical therapy) did not improve your pain.

A cervical medial branch block is done when you’re having pain in your neck region to block the nerves feeding the facet joints in that area. A thoracic medial branch block involves blocking the nerves supplying the facet joints in your mid-back. Similarly, a lumbar medial branch block is done to block the nerves in the lower back in patients with lower back pain.

No, a medial branch block is primarily a diagnostic procedure, not an actual “fix” for your pain. When patients find pain relief with medial branch block, they are good candidates for the radiofrequency ablation treatment of the medial branch nerves. In comparison, radiofrequency ablation offers longer-term pain relief in cases where a medial branch nerve block shows that a patient’s pain originates from a facet joint. Radiofrequency ablation uses radio waves to burn off damaged nerve tissue as opposed to a medial branch block, which involves injecting the numbing medication into the nerves.

Most patients will find relief within the first few hours of the injection. If there’s no relief, it is likely that the medial branch nerves were not the cause of pain.

No, a medial branch block is not the same as an epidural. An epidural steroid injection is used to treat sciatica (pain that starts from your lower back and goes all the way down to your legs)—caused by conditions such as a slipped disc or spinal stenosis (narrowing). On the other hand, a medial branch block is used to detect whether or not the pain is coming from the facet joint supplied by that nerve.

Moreover, epidural steroid injection involves injecting the steroid into the epidural space that lies outside the outermost layer enveloping your spine where the nerves are inflamed. In contrast, a medial branch block involves injecting the numbing agent into the space around your facet joints.

If you don’t experience relief from the medial branch block, it is likely that your pain is not coming from the facet joints. If this happens, your physician will carry out other tests to pinpoint the source of your pain.