Cervical Medial Branch Blocks for Chronic Neck Pain & Headaches

Cervical Medial Branch Blocks for Chronic Neck Pain & Headaches

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What are cervical facet joints?

Facet joints are found on both sides of the spine.  Each is about the size of a thumbnail.  Cervical facet joints are named for the vertebrae they connect and the side of the spine where they are found.  The right C3-4 facet joint, for example, joins the 3rd and 4th vertebrae on the right side.  Facet joints not only connect the vertebrae, but they also guide the spine during movement.

 

What is cervical facet joint pain?

Cervical facet joint pain is the result of joint dysfunction, either due to injury or irritation.  Pain from an irritated cervical facet joint may range from simple muscle tension to more severe pain.  Depending on which facet joint is affected, the pain may occur in an area from the head down to the shoulder blades.

 

How do I know if I have cervical facet pain?

If you have pain in one or more of these areas when you turn your head, and it has lasted longer than a few months, you may have cervical facet pain.

 

What is a cervical medial branch block?

During this procedure, an anesthetic is injected over the medial branch nerve, which temporarily stops the transmission of pain signals from the facet joint.  The injection is done only to diagnose pain coming from a chronically irritated facet joint.  If the injection temporarily lessens your neck pain or headache, then the doctor can be certain that the intended joint is the one causing the majority of your pain.

 

What happens during an injection?

Unless otherwise discussed with your physician, you will not be receiving sedation for this procedure.  It is recommended that you eat a normal meal prior to the procedure.  A local anesthetic will be used to numb the skin.  The doctor will then insert a thin needle directly into the facet joint.  If at any point in time the procedure becomes painful, you should let the doctor know.  Fluoroscopy, a type of x-ray, will be used to ensure the safe and proper position of the needle.  A dye will also be injected to make sure the medicine will go into the correct spot.  Once the needle is in the correct location, an anesthetic will be injected.

 

What happens after an injection?

You will be monitored for approximately 30 minutes after the procedure.  Before you leave the clinic, you will be given discharge instructions.  It is crucial that you keep track of your pain after the procedure as this will help your doctor determine the next step in treatment.  You should check for pain by moving your neck or head after the procedure, but do not overdo it.  You should be able to return to work the day after the procedure.

 

How long can I expect pain relief?

Pain relief will only last for a few hours.  Any relief greater than eight hours is not the direct effect of the anesthetic but more due to relaxation of the painful muscles as a result of the needle itself.  If your typical pain is significantly reduced for a few hours after the procedure, you may be a candidate for a radiofrequency neurotomy of the medial branch nerve.  This procedure provides more permanent pain relief.   

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