Medial Branch Blocks are injections specifically designed to help diagnose if pain is coming from facet joints. The injection numbs the medial branch nerves, which are located in the joints of the spine called facets. If the patient is relieved by the medial branch block, then the cause of the pain is most likely related to the facet joints. 

The Facets are small bony joints that connect one vertebrae of the spine to another in the back of the spinal canal. Each vertebral segment has two facet joints, one on each side. These joints provide stability and control but also allow for motion in the spine, for example bending and twisting. The nerves that supply these facet joints are called the medial branch nerves. These small nerves feed out from the facet joints in the spine and carry pain signals from the facet joints to the brain.

The facet joints in the neck and back can cause pain and discomfort just as any other joint in the finger, knee, or hip. If these joints are arthritic or injured they can cause pain. 

Medial branch blocks target the medial branch nerves that carry pain signals from the facet joints to the brain. If the medial branch blocks provide temporary relief, this indicates that the patient is a good candidate for radiofrequency ablation. These injections are performed with an anesthetic and a corticosteroid.


The patient will lie either face down on a table or on their side with a pillow supporting the curve of the neck. The injection area is cleaned and numbed before the injection. Using fluoroscopic (X-ray) guidance, the physician will determine the appropriate path for the needle.

The doctor will insert a thin needle to the appropriate area(s) for the block. Next, the doctor will inject a small amount of contrast dye to make sure that the medication will flow exactly where intended. After that, the physician will inject a small amount of long-acting anesthetic.

There is no down time following this injectio, and the patient can resume with their normal daily activities immediately.