I have been under the care of Dr Ramirez for the past 8 years and can honestly say that if it wasn’t for him and his staff, my life wouldn’t be worth living. After many years of a pain filled existence, I was fortunate enough to be referred to Dr Ramirez who took a sincere interest in my back, leg, spinal and emotional problems (due to an injury sustained while I was in the Army back in 1969) and his treatment has allowed me to live a much improved quality of life than I had previously experienced for the past 30+ years. It’s so refreshing to have a healthcare professional who actually listens to my concerns and problems and in turn treats these issues in a calm, professional and reassuring manner. Should you have issues with constant pain that interferes with your everyday quality of life, don’t give up. Go see Dr. Ramirez, you’ll be glad that you did.
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.
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
- 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.