Cervical Medial Branch Blocks
Cervical medial branch blocks are precise diagnostic injections that temporarily numb the medial branch nerves — the sensory nerves that transmit pain from the cervical facet joints to the brain. These blocks are the necessary first step before proceeding to cervical radiofrequency ablation for long-lasting facet joint pain relief.
The Role of Cervical Facet Joints in Neck Pain
The cervical facet joints allow the neck to bend and rotate while providing structural stability. With age, injury (especially whiplash), and degeneration, these joints can become arthritic and painful. Cervical facet pain is a very common but frequently under-diagnosed cause of neck pain, headaches, and shoulder pain.
Signs that suggest cervical facet involvement:
- Neck pain that worsens with extension (bending the head backward) or rotation
- Referred pain to the occiput (back of the head), shoulders, or upper back — but not to the arms
- Tender points directly over the cervical spine on palpation
- History of whiplash or motor vehicle accident
Diagnostic Block Protocol
Two sets of medial branch blocks are typically required (on separate occasions) before radiofrequency ablation can be performed. This two-block protocol is the evidence-based standard for confirming facet-mediated pain and ensuring that only appropriate candidates proceed to ablation.
- Block 1: Local anesthetic injected at each target nerve level
- If positive: Block 2 performed on a separate visit with the same or different anesthetic
- If both blocks positive: Patient proceeds to cervical radiofrequency ablation
The Procedure
Under fluoroscopic guidance, small amounts of local anesthetic are injected at each medial branch nerve level being tested. Multiple levels are typically blocked in a single session. The procedure takes 20–30 minutes.
Path to Long-Lasting Relief
A successful medial branch block is the gateway to cervical radiofrequency ablation — a procedure that can provide 12–18 months of relief from cervical facet pain with a single treatment. If you've been told that radiofrequency ablation was not covered or that you're not a candidate, confirm with our office — proper documentation of two positive blocks is required and often not performed elsewhere.
Contact Us
Call 516-492-3100 to begin the diagnostic process for cervical facet-mediated neck pain.