Pain Management Physician

Medial branch nerve blocks are a diagnostic test for facet joint arthropathy.  This test can be done in the cervical, thoracic, and lumbar spines.  I perform this procedure under intermittent X-ray guidance to localize the exact area of the nerve.  Each facet joint has two nerves that supply it.  By performing a local anesthetic block, facet arthropathy can be diagnosed or excluded.  After the injection, facet-loading maneuvers are performed.  In the low back, I have the patient bend back at the waist and to the affected side.  In the neck, this is done by the patient laterally flexing the neck (touching the ear to the shoulder).  If the pain is absent after the block, a diagnosis can be made.  This normally will only result in short-term relief.  However, with this information, radiofrequency ablation of these nerves can now be performed.  That will result in long-term relief.