ProcedureImage-guided injections
Facet joint & medial branch blocks
Facet joints are a common source of back and neck pain and cannot be identified reliably on a scan. Blocking them under imaging answers the question directly — and a clear answer opens the door to a longer-lasting treatment.
What it is
Local anaesthetic is placed either into the facet joint or onto the medial branch nerves that supply it. If those nerves are carrying the pain signal, the pain settles for as long as the anaesthetic lasts.
Who it suits
- Back or neck pain worse with extension, twisting or standing
- Pain that refers to the buttock or shoulder blade but not down the limb
- Whiplash-associated neck pain
- Anyone being considered for radiofrequency neurotomy — the block comes first
On the day
Performed prone under X-ray guidance with local anaesthetic. Because the result is diagnostic, sedation is used sparingly — it can blur the answer.
You are given a simple diary and asked to record your pain hourly for the first eight hours. That record decides the next step.
Afterwards
Normal activity from the same evening. A good but temporary response is the ideal result: it confirms the source, and makes you a candidate for radiofrequency neurotomy, which lasts far longer.
No response is also useful — it rules the joint out, and we look elsewhere rather than repeating.
Risks
- Soreness at the needle site for a day or two
- Temporary numbness or heaviness in the area
- Bleeding or infection — uncommon
- A short-lived flare of the usual pain
A note on this page
This is general information, written to help you prepare for a conversation. It is not a substitute for an individual assessment — what is right for you depends on your history, your examination and your own goals.
Common questions
Asked before, answered here
Local anaesthetic is meant to. This block is a question, and the answer determines the durable treatment.
Often yes. A confirmatory second block reduces false positives before committing to neurotomy.
Costs are confirmed in writing before anything is booked. Published ranges are on the fees page.
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Ask whether this suits you
Suitability is decided after an assessment, never from a form. Tell us where you are up to and we will advise honestly.
Visit
Level 2, 48 Macquarie StreetSydney, NSW 2000Response
Enquiries are answered within one to two business days. Urgent clinical matters are triaged the same day by the practice team.