Blockage of the facet joints in the neck

Why do I have to do this procedure?

Your doctor suspects that your neck pain may be coming from small joints in your spine called facet joints. These joints help your neck move and stay stable, but over time they can become irritated or worn, causing pain in your neck, shoulders, upper back, or even headaches.

To determine whether the pain is actually coming from these joints, we perform a test called facet joint block.

What is a facet joint block?

It is not a treatment, but a diagnostic test.
A small amount of local anesthetic is injected near the nerves that transmit pain from the facet joints to the brain.

If the pain decreases after the injection, it means that these joints are likely the cause of your pain.

Before the Procedure: What to Know

Inform your pain specialist if:

You have a fever or feel unwell
You have allergies to medications, local anesthetics, or contrast agents
You are taking anticoagulant medications (they may need to be suspended)
You are pregnant (the procedure uses X-rays and will be postponed)

How to Prepare

You can take your usual medications, unless otherwise instructed regarding anticoagulants.
Hospitalization is not necessary: it is an outpatient procedure.
After the procedure, you will not be able to drive: arrange for someone to accompany you.

How Does the Procedure Work?

You will lie on your side with your neck well supported.
The skin is disinfected.
The doctor inserts a thin needle near the nerve, using radiological guidance.
A small amount of local anesthetic is injected.
The procedure takes about 15 to 30 minutes.
After a short rest, you can go home (with an escort).

What Happens Afterwards?

After the injection, we will ask you to perform movements that normally cause pain (such as turning your neck or working on the computer).
We will give you a form to fill out, marking your pain level before and after the injection.
This will help us understand if the treatment has worked.

Why are Two Tests Necessary?

To have a more reliable confirmation.
The test is repeated on another day: if both times the pain improves, we know the problem comes from the facet joints.

And if the Tests are Positive?

If both tests provide relief, we can offer you a more lasting treatment:
Radiofrequency of the facet joints.

A special needle transmits heat to the nerve, interrupting the pain signal.
The relief can last from 6 months to 2 years.
TI-DOLORE is internationally recognized for its expertise in this treatment. He has been the protagonist of a groundbreaking study demonstrating the efficacy of multinede needle radiofrequency.

Koetsier E, Künzle A, van Kuijk SMJ. Efficacy of Cervical Facet Joint Radiofrequency Ablation Using a Multitined Cannula. Pain Physician. 2023.

Are there Risks or Side Effects?

The procedure is generally safe. Possible side effects include:

Mild pain or bruising at the injection site
Temporary feeling of numbness
Rarely infection or allergic reaction

Remember:

Do not drive for 24 hours after the procedure.
Arrange for someone to accompany you.
Fill out the form carefully and return it to your pain doctor.
If the first test goes well, the second one will be scheduled.

Lifestyle Interventions

Attività fisica (passeggiate, stretching), sonno regolare, alimentazione equilibrata e tecniche di riduzione dello stress possono migliorare la resilienza e potenziare l’efficacia delle terapie mediche.

Psychological Support

The management of chronic pain can be aided by psychological interventions (such as relaxation techniques or cognitive behavioral therapy), which help reduce anxiety, insomnia, and the impact of pain on quality of life.