facet joint block
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At the Center for Pain Relief, we treat patients with compassion and respect as we help them manage their pain. Located at the Medical Office Building at Pine Creek Medical Center in Dallas, our center primarily focuses on interventional pain management but also incorporates medical pain management.


I have been a patient of Dr. Manuel Ramirez for the last 18 years. I have a disease called RSD/CRPS or Reflex Sympathetic Dystrophy/Chronic Regional Pain Syndrome. It is a nerve problem which causes deteriorating bone problems and is very painful. He initially diagnosed me and has been treating my pain with success all these years and I claim him as “family.” He is professional, but also very caring, intelligent and kind and is a great listener.
Lou Ann T.Ardmore, Oklahoma

Facet Joint Blocks/Medial Branch Nerve Blocks

The joints that connect one spine to the other that allow flexibility are called facet joints.  The tiny nerves that communicate pain caused by the facet joints as a result of injury from trauma or arthritis are called the medial branch nerves.  The nerve is located at a bony groove in the low back and neck.  These nerves can be blocked with an anesthetic and if it is effective but the results are short lived then a longer lasting pain relief could be achieved by lesioning (destroying the nerve) with radiofrequency rhizotomy.  We can do away with these nerves as they do not mediate the important functions of motor nor sensory.

About Facet Joint Blocks

Facet joints are the joints in the spine that afford the back its flexibility and enables it to bend and twist. It is here that nerves leave the spinal cord on their way to other areas of the body.

A facet joint block is the process of injecting a local anesthetic to numb the area and/or a corticosteroid medication to relieve pain in the facet joints. They literally block the pain signals from reaching the brain.

About the Facet Joint Block Procedure

The facet joint block is done via fluoroscopy (X-ray) to help guide the needle. Per the doctor’s discretion, an intravenous (IV) line may be used to administer medication to help the patient be at ease during the procedure. The patient’s back will be numbed with injections of local anesthetic in the area the block will be given. A slight burning sensation may be felt, but will subside quickly.

Using the aforementioned fluoroscopy, longer needles are placed into the facet joints along the spine and a local anesthetic (possibly accompanied by a corticosteroid) is injected. The local anesthetic will act as a numbing agent and may relieve the pain by itself. However, if the pain is more serious or the patient is experiencing inflammatory conditions, the corticosteroid will be added to ensure proper pain management.

Risks of Facet Joint Blocks

As with most procedures, there is a remote risk of adverse effects when administering medicine and/or surgery. Injections are considered minimally invasive treatments, so serious side effects are rare. However, some temporary conditions a patient may encounter are:

  • Muscle soreness and/or weakness near injection site
  • Numbness near injection site
  • Bleeding at injection site
  • Infection
  • Nerve injury
  • Allergic reaction to the medications used

Further, patient may experience increased pain for a few days after the procedure, especially at the injection site(s.)

Quick Look: Facet Joint Syndrome

One painful condition that effects the facet joints is called facet joint syndrome, an arthritis-like condition where the back and neck experience extreme discomfort. Over time, degenerative changes to the facet joints between the spinal bones cause the joints to wear down and become inflamed.

While there are several medical procedures to combat this condition, facet joint blocks are a great option if physical therapy and pain medication prove unsuccessful.