Cervical medial branch block overview
Diagnosing facet joint pain in the neck
A cervical medial branch block is a diagnostic test to ascertain whether pain in the neck area (and sometimes affecting the upper back, shoulder and side of the head) is arising from the facet joints (see facet joint syndrome for more on the facet joints) in the cervical spine, that is the section of the spine at the neck, comprising vertebrae C1 to C7.
The test works by temporarily interrupting pain signals from this area transmitted to the brain via the medial branch nerves (that supply sensation from the facet joints), by injecting a small quantity of local anaesthetic directly to these nerves.
Where pain is significantly reduced, this indicates that the facet joints are the source of the pain, in which case further treatment may be recommended such as cervical facet radiofrequency neurotomy.
A cervical medial branch block generally lasts for 24-48 hours, but in some (relatively rare) cases it may continue to suppress pain for weeks or even months.
To accurately diagnose facet joint related pain, you will generally need two (or more) cervical medial branch blocks.
Cervical medial branch block indications and preparation
Preparing for your diagnostic procedure
A cervical medial branch block may be recommended for neck pain that is potentially arising from the facet joints.
As this is primarily a diagnostic procedure, it is important that your usual pain can be reproduced at the time of the procedure. You should stop taking pain medication around 5-6 hours beforehand. If you do not have pain on the day of the procedure, we may suggest postponing it.
You should avoid other medical procedures, such as dental treatment or a colonoscopy, within 48 hours before or after the cervical medial branch block.
Please let us know before the procedure if:
- You are taking antibiotics.
- You have a pacemaker or defibrillator.
- You are unwell, as the procedure may need to be postponed.
You should also arrange for someone else to drive you to and from the appointment.
After your cervical medial branch block
Recovery and monitoring after the procedure
After the procedure you are able to return home, with no restriction on normal day-to-day activities.
In some relatively rare cases, you may experience mild discomfort or bruising at the injection site.
You will also be asked to complete a 24-hour pain diary to record any changes in your usual pain following the procedure.
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