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Medial Branch Block

-this diagnostic procedure is performed to identify a painful facet joint -the facet joints are the joints between the vertebrae in the spine -they allow the spine to bend, flex and twist -in preparation for the procedure, the patient is positioned on his stomach -the physician injects a local anesthetic -this numbs the skin and tissue around the facet joint that is suspected of causing the patient's pain -once this tissue is numb, we insert a needle into the skin -the needle is carefully guided down to the facet joint -the physician injects a contrast solution through this needle -the contrast solution helps us see the area on a camera called a fluoroscope -the fluoroscope provides live x-ray images -we then use the fluoroscope to confirm the location of the needle's tip -once we have confirmed that the needle is positioned correctly, we attach a syringe containing an anesthetic medication -this medication is injected around small nerves called the medial branch nerves -these carry signals to and from the facet joints -the anesthetic will temporarily block sensation in these nerves -if the temporary injection relieves the patient's pain, the physician may inject a more long-lasting anesthetic and ultimately radiofrequency ablation