Diagnostic & Therapeutic Injections for Neck Pain, Back Pain, and Cervicogenic Headaches
Chronic neck pain, back pain, and certain types of headaches are often caused by inflammation or arthritis of the facet joints—the small joints that connect the vertebrae of the spine. When these joints become irritated, the medial branch nerves transmit pain signals from the spine to the brain.
At TOPS Institute, our board-certified pain management specialists perform fluoroscopy-guided medial branch blocks to help diagnose and relieve pain originating from the cervical, thoracic, and lumbar facet joints. These minimally invasive procedures can help determine whether the facet joints are the source of your pain and may identify patients who are candidates for longer-lasting treatment with Radiofrequency Ablation (RFA).
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What Is a Medial Branch Block?
A medial branch block is an image-guided injection that targets the medial branch nerves, which carry pain signals from the facet joints of the spine. By temporarily numbing these nerves with a local anesthetic, your physician can determine whether the facet joints are responsible for your symptoms.
Unlike an epidural steroid injection, which treats inflammation around spinal nerves, a medial branch block specifically evaluates pain arising from the facet joints.
The procedure may be performed for:
- Chronic neck pain
- Chronic mid-back pain
- Chronic low back pain
- Cervicogenic headaches
- Facet joint arthritis
- Degenerative spinal conditions
- Persistent pain after whiplash injuries
- Pain that worsens with twisting or extension
Conditions Commonly Treated
Medial branch blocks may be recommended for patients with:
- Cervical facet syndrome
- Lumbar facet syndrome
- Facet joint arthritis
- Cervical spondylosis
- Lumbar spondylosis
- Degenerative disc disease with facet involvement
- Chronic neck pain
- Chronic low back pain
- Cervicogenic headaches
- Pain following motor vehicle accidents
- Persistent pain after spinal injuries
Following a comprehensive evaluation, your physician will determine whether your symptoms are likely to originate from the facet joints.
Cervical Medial Branch Blocks
Cervical medial branch blocks target the nerves that supply the facet joints in the neck. These joints are a common source of chronic neck pain and may also contribute to headaches that begin in the upper cervical spine.
Patients may benefit from cervical medial branch blocks if they experience:
- Chronic neck pain
- Pain that worsens with turning the head
- Pain after whiplash injuries
- Neck stiffness
- Pain at the base of the skull
- Cervicogenic headaches
- Arthritis of the cervical spine
Using fluoroscopic guidance, medication is precisely placed around the targeted medial branch nerves to maximize accuracy and safety.
Lumbar Medial Branch Blocks
Lumbar medial branch blocks are performed to evaluate pain arising from the facet joints of the lower back.
Patients may be candidates if they have:
- Chronic low back pain
- Lumbar facet arthritis
- Pain when standing or walking
- Pain with bending backward
- Degenerative lumbar spine disease
- Mechanical back pain
- Pain that has not responded to conservative treatment
This procedure helps determine whether the lumbar facet joints are contributing to your symptoms and whether Radiofrequency Ablation may provide longer-lasting relief.
Cervicogenic Headache Injections
Not all headaches originate within the brain. Cervicogenic headaches begin in the cervical spine and are commonly caused by irritation of the upper cervical facet joints, muscles, or surrounding nerves.
For carefully selected patients, cervical medial branch blocks may help identify facet joint pain as the source of these headaches.
Symptoms of cervicogenic headaches may include:
- Pain that begins in the neck
- Headaches radiating to the back of the head
- Pain behind one eye
- Reduced neck mobility
- Headaches worsened by neck movement
- Pain after prolonged sitting or poor posture
If medial branch blocks provide significant temporary relief, patients may be candidates for Radiofrequency Ablation, which can offer longer-lasting pain reduction.
How the Procedure Is Performed
Medial branch blocks are performed on an outpatient basis using fluoroscopic (X-ray) guidance.
During the procedure:
- The skin is cleaned and numbed with a local anesthetic.
- Using live X-ray imaging, your physician carefully positions a small needle near the targeted medial branch nerves.
- A small amount of local anesthetic, and in some cases additional medication when clinically appropriate, is injected around the nerves.
- The needle is removed, and patients are monitored briefly before returning home.
Most procedures are completed in less than 30 minutes.
What to Expect After Treatment
Patients are often asked to monitor their pain levels over the next several hours after the procedure.
Temporary pain relief may indicate that the targeted facet joints are contributing to the symptoms.
If significant relief is achieved, your physician may recommend additional treatment, including Radiofrequency Ablation (RFA), which can provide longer-lasting pain relief by interrupting pain signals from the medial branch nerves.
Individual results vary depending on the underlying diagnosis and response to treatment.
Benefits of Medial Branch Blocks
Depending on the individual patient, medial branch blocks may:
- Help identify the source of chronic spinal pain
- Provide temporary pain relief
- Improve daily function
- Guide future treatment decisions
- Determine candidacy for Radiofrequency Ablation
- Reduce pain during movement
- Improve participation in physical therapy
- Delay or reduce the need for more invasive procedures
Why Choose TOPS Institute?
Patients throughout Los Angeles, Beverly Hills, and Southern California trust TOPS Institute because we provide:
- Board-certified pain management specialists
- Advanced fluoroscopy-guided procedures
- Expertise in diagnosing facet joint pain
- Personalized treatment plans
- Minimally invasive outpatient procedures
- Concierge-level patient care
- Comprehensive follow-up and treatment coordination
- A focus on non-opioid pain management whenever appropriate
Our goal is to accurately identify the source of your pain and develop a treatment plan that helps restore mobility and improve your quality of life.
Frequently Asked Questions
Is a medial branch block the same as an epidural steroid injection?
No. A medial branch block targets the small nerves that carry pain signals from the facet joints, while an epidural steroid injection delivers medication into the epidural space to reduce inflammation around irritated spinal nerve roots.
Is a medial branch block painful?
Most patients tolerate the procedure well. A local anesthetic is used to numb the skin before the injection, and fluoroscopic guidance helps ensure precise needle placement.
How long does pain relief last?
Some patients experience temporary relief lasting several hours or days, while others may notice improvement for a longer period. The primary purpose of the procedure is often diagnostic, helping determine whether the facet joints are the source of pain.
What happens if the injection works?
If you experience significant temporary pain relief, your physician may recommend Radiofrequency Ablation (RFA), which can provide longer-lasting pain relief by disrupting pain signals from the treated medial branch nerves.
Learn More About Radiofrequency Ablation →
Will I need more than one injection?
Some patients may require additional diagnostic injections before proceeding with Radiofrequency Ablation. Your treatment plan will depend on your diagnosis, response to the procedure, and overall clinical evaluation.
Schedule Your Consultation
If chronic neck pain, low back pain, or cervicogenic headaches are limiting your daily life, a medial branch block may help identify the source of your symptoms and guide the next step in your treatment.
At TOPS Institute, our specialists provide advanced, image-guided interventional pain management using evidence-based techniques tailored to each patient’s condition and goals.
Call 310-694-9494 or request an appointment online to schedule your consultation. We proudly serve patients throughout Los Angeles, Beverly Hills, and Southern California with personalized, minimally invasive pain management and concierge-level care.
