Spine has many vertebrae and small joints called facet joints link them to each other. The main function of these joints is to provide stability while allowing some degree of movement. These joint commonly become painful and stiff as a result of wear and tear, inflammation or injury. The resulting pain is generally described as a dull ache, heaviness that can radiate towards head, shoulder and scapula.
Investigations such as x-rays and MRI may or may not show joint changes. MRI findings alone cannot be relied on to make the diagnosis, as every arthritic joint is not painful. A more reliable test to determine if these joints are responsible for your pain is accurately placed neck injections and if the pain reduced significantly then these joints are the likely source of pain.
Injections for facet joints are performed under x-ray or ultrasound guidance as a day case procedure. The procedure involves placing needles at the precise location under x-ray guidance followed by injection of local anaesthetic and steroid mixture in or around the joints. It may take a few days and sometimes weeks for the full effects of the injections to become apparent.
Medial branch Blocks
These injections are used as tests to diagnose facet joint pain and assess whether the radiofrequency treatment will be beneficial or not. The target in these injections is the nerves carrying the pain sensation from the facet joints (compared with the joints themselves in facet joint injections). The procedure involves placing a small amount of local anaesthetic at specific locations under x-ray guidance. The resulting nerve block temporarily abolishes the pain if the source of pain is the facet joints. The decision to proceed with radiofrequency is taken based on the degree and duration and of pain relief obtained from these diagnostic injections.