Cervical Medial Branch Blocks Injection

Diseases for which injection may help:

  • Cervical spondylosis
  • Cervical facet arthopathy
  • Cervical degenerative disc disease
  • Headache
  • Neck pain
  • Shoulder pain
  • Facial pain

Reason for injection:

  • To diagnosis pain from the cervical facet joint - formed in the back of the spine
    where the bones in the spine contact each other
  • Pain mostly in the neck but can travel over your shoulder blade and down the arm
  • Conservative measures such as ice, rest, anti-inflammatory medication, neuropathic medication, and physical therapy are tried first
  • Goal of injection is to see if a small amount of local anesthetic placed placed on the nerves that transmit the pain from this joint decreases or eliminated your pain
  • If your pain is reduced by 50 percent or more, it is likely that you will benefit from a radiofrequency procedure
  • Local anesthetic will wear off in a few hours and your pain will likely return
  • Radiofrequency procedures have been shown to work for periods of six months to a one year

Description of procedure:

  • Performed in a surgery center as an outpatient procedure at Moores Cancer Center
  • Check in 30 minutes before procedure; staff will answer any questions before procedure
  • Your back will be cleaned with antiseptic solution and an x-ray will identify spot for injection
  • Local anesthetic numbs the skin and a needle will be used to enter the epidural space
  • Small amount of x-ray contrast will be injected into the needle to confirm needle is in right place
  • Some patients feel pressure in the back or down their legs when medication is injection
  • A small Band-Aid will be applied to your back and you will be taken back to recovery
  • Discharge instructions will be reviewed and you will be able to go home as soon as you are ready
  • If your pain relief is greater than 50 percent in the recovery area, you will be given the option of scheduling a radiofrequency procedure or return visit to the clinic

Medications used for the injection:

  • Most often only local anesthetic, such as bupivicaine or lidocaine, is injected
  • Occasionally, corticosteroids are injected, which decrease inflammation
  • Usually, the corticosteroid used is Dexamethasone or Betamethosone

Pre-op instructions:

  • Suggested you have a driver
  • Review all your medication with us before the procedure
  • If you take medication that affect your ability to form a blood clot (anticoagulants, such as Coumadin, Plavix, Lovenox) a specific plan should be in place - consult with physician
  • All other medications should be taken as normal unless your physician tells you otherwise
  • If you have any questions about your medications, please call the pain clinic 858-657-6035

Post-op instructions:

  • Take it easy day of injection and return back to normal activity the following day
  • You may return to physical therapy after the injection, but let your therapist know you have undergone procedure

Potential side effects or risks:

  • Site of injection can be sore after
  • Local anesthetic will last only four to six hours, so pain will return after medication wears off
  • Other risks, which are rare, include infection, bleeding, nerve damage, bowel/bladder problems, and sexual dysfunctions
  • If you have any specific questions about these risks, please speak with your doctor before the procedure

Follow up and further care:

  • After the procedure you will be given instructions on how and when to follow up
  • Either you will be scheduled for a radiofrequency procedure or you will be scheduled for a follow up at the pain clinic

Center for Pain Medicine
Perlman Medical Offices
9350 Campus Point Drive, Suite 2C
La Jolla, CA 91111
and 858-822-6110