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    • Facet Joint (Zygapophysial) Injections (Intra-articular, Medical Branch Block)

Facet Joint (Zygapophysial) Injections (Intra-articular, Medical Branch Block)

The facet joints are common sources of pain; they are often affected by degenerative arthritis or acute injuries such as whiplash. In the neck, pain referred from this joint might manifest as headaches, shoulder pain, and upper back pain. These joints can cause low back, buttock, or thigh and leg pain when originating in the lumbar spine. These joints are located in the posterior aspect of the spine and are responsible for ~10-15% of the support attributed to the spine. During intra-articular injections, the joints are penetrated with a needle followed by injection of contrast to confirm placement. Then a combination of local anesthetic and steroid are injected. Medial branch blocks involved the injection of a small amount of local anesthetic at the two small nerves that supply each facet joint. This highly specific procedure is diagnostic, often predicting success with radiofrequency ablation.