What Causes Chronic Neck Pain (Cervical Facet Joint Pain)?
One of the common causes of chronic neck pain (cervical facet joint pain) is the inflammation or degeneration of small facet joints (also known as facet joints). These joints are located in the neck.
How Can it be Treated?
Medial Branch Block (MBB)
Patients experiencing persistent neck pain may be advised to go for a Medial Branch Block (MBB) procedure, where a local anaesthetic is injected to the medial branch nerves that affects the facet joints to temporarily numb the pain.
Before the start of the procedure, patients will be instructed to lie on their back or side. Local anaesthetic will be given to numb the skin around the area of injection.
Under the guidance of X-ray or ultrasound, a needle will be inserted to the medial branch nerve that affects the facet joints (refer to the image). Local anaesthetic (with or without steroid) is then injected to numb the nerves.
Cervical Facet Joint Denervation
In cases where MBB procedure was effective in reducing the pain, patients may then be advised to go for facet denervation where the medial branch nerve is burnt for a longer lasting pain relief. This procedure is usually done when the pain relief from MBB procedure has gone away.
The facet denervation treatment procedure is similar to the MBB procedure. However, instead of injecting local anaesthetic, electrical currents are applied to burn the nerve for pain relief. This technique is known as the radiofrequency ablation.
What are the Risks of the MBB Procedure?
The risks from the procedure are generally low, although they may still occur. Some of the risks include:
- Complications from the medication given (e.g. allergic reaction)
Who is Suitable for MBB and Cervical Facet Joint Denervation?
A person who has the following symptoms may be considered for the procedures:
- Experiences significant pain in the neck that affects one’s mood and daily functioning
- Shows no signs of improvement with conservative treatment with medication and physiotherapy
- Has no allergy towards anaesthetic medications