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Back Pain Treatment

Medial branch blocks can be used independently to provide long-term back pain relief. They can also be used to precisely identify the facet joints as the cause of pain, and are the preliminary procedure prior to radiofrequency neurotomy of the medial branch nerves.

A medial branch block interrupts the sensory nerve supply to the involved facet joint through the use of a precise administration of an anesthetic agent and steroid. After a local skin anesthetic is applied, the physician uses fluoroscopy (x-ray) guidance to place a needle along the nerves that supply the inflamed joint.

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Facet Blocks for Lower Back Pain

Facet joint blocks are typically requested for patients who have pain primarily in their back as a result of arthritic changes in the facet joints or for patients who have mechanical low back pain. A lumbar facet joint block is an injection of local anesthetic into one or more of the small joints located along the side of each vertebra on both sides of the spine in the lower part of the back. Multiple injections may be performed, depending upon how many joints are involved. A facet joint block may be diagnostic (a test to see if your pain is coming from this area) and/or therapeutic (to relieve your pain).

The facets are the small, bony joints that connect the spine’s vertebrae. These joints provide stability and control but also allow for motion in the spine, so that you can bend and twist. Each vertebral segment has two facet joints, one on each side. The lumbar facet joints guide and motion in the lower back.

Just as a joint in your finger, knee, or hip can cause you discomfort, so can the facet joints in your back. They can become arthritic or injured, causing pain. If you are experiencing any pain that is mostly in the back and with a less specific, vague aching in the legs (one or both), it may be coming from one or more of these small joints in the lumbar (lower back) area. The goal of facet joint injections is to decrease pain and inflammation in the facet joints by injecting a steroid (a strong anti-inflammatory medicine) into the joint.

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