Facet joints are found on either side of the spine. Each of these joints is about the size of a thumbnail. In the Thoracic spine there are 12 vertebrae and ribs that are connected by facet joints.
Facet joints connect vertebrae to one another along with guiding the spine when moving.
Medial branch nerves are located near facet joints. They communicate pain from facet joints. Therefore these nerves tell the brain when the facet joint has been hurt.
Injury to a facet joint typically involves damage to cartilage inside the joint and connecting ligaments surrounding the joint.
Pain from an injured thoracic facet joint may range from muscle tension/tightness to more severe pain. This pain can radiate into different areas, depending on which facet joint is hurt.
What is a Thoracic Medial Branch Block (MBB)?
This outpatient procedure is used to help with diagnosing upper and middle back pain.
Medial Branch Block Procedure
A thin needle is inserted near the facet joint under fluoroscopy (a type of x-ray). Fluoroscopy is used to position the needle accurately and safely. A small amount of dye is used by the Physician to assess if the needle is in the proper position. This injected dye can cause some discomfort.
With the correct needle position the area will be numbed with an anesthetic medication.
Do I have Thoracic Facet Joint Pain?
If you have pain for greater than 2 months in the upper and middle back pain, you may have thoracic facet joint pain.
Tests such as X-rays or MRIs do not always show if the facet is the reason for your pain. The best way to test if you have pain from these joints is to block the pain signal being sent from the medial branch nerves.
A Thoracic MBB disrupts the normal function of the medial branch nerve. The medial branch nerve is then no longer able to transmit pain signals from the painful facet.
How Long Should the Pain Relief Last?
After your Thoracic Medial Branch Block procedure you will be monitored for approximately 15 – 30 minutes. The clinic will give you appropriate directions to follow as well as filling out a pain diary. This pain diary is very important as it will guide the Physician treatment plan for you.
Pain relief will typically last for 4-6 hours, until the anesthetic wears off.
Short term pain relief is considered a positive test. The physician will determine the next step in your treatment plan.
Post procedure soreness may be experienced. Typically this soreness is caused by muscle and nerve irritation.