Villanueva Institute of Pain and Spine
Medial Branch Block Injections in Burbank | Facet Joint Injections
Medial branch block injections and facet joint injections help identify whether the small joints in your spine are causing neck or back pain. Deep, aching, or stiff pain that worsens with standing, twisting, or bending backward may indicate facet joint involvement.
For some patients, these injections provide meaningful relief. For others, the most important benefit is clarity because your response helps guide whether another treatment, such as radiofrequency ablation, may be appropriate. Either way, my goal is for you to feel informed, listened to, and more confident about the path forward.
I am Dr. John Villanueva, a double board-certified PM&R and interventional pain management expert. At the Villanueva Institute of Pain and Spine (VIPS), my team and I use image-guided spine injections to accurately evaluate and treat pain. Our process starts with identifying the source of your pain and developing a clear plan to help you move, work, sleep, and function with greater confidence and comfort.
If you are considering medial branch block injections or facet joint injections in Burbank, CA, call VIPS at (818) 669-8895 or request an appointment online. We are located in Burbank and proudly serve patients visiting from Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.
Quick Links
- What Are Facet Joints?
- What Are Medial Branch Block Injections?
- What Are Facet Joint Injections?
- Medial Branch Blocks Vs. Facet Joint Injections
- What Symptoms Can Facet Joint Injections And Medial Branch Blocks Help Evaluate?
- Good Candidates For Medial Branch Block Injections Or Facet Joint Injections
What Are Facet Joints?
Facet joints are small joints located along the back of the spine. They help guide motion and provide stability when you bend, twist, stand, and move. Like other joints in the body, they can become irritated, inflamed, arthritic, or painful over time.
Facet joint pain can affect the cervical (neck), thoracic (mid-back), or lumbar (low back) regions of the spine.
Facet-related pain is often connected to arthritis, degenerative disc disease, spinal wear and tear, prior injury, whiplash, altered mechanics, or pain after spine surgery. Since spine pain can come from several possible sources, a careful evaluation is important before deciding which treatment makes sense.
What Are Medial Branch Block Injections?
Medial branch block injections are targeted injections that help determine whether pain is coming from the facet joints. The medial branch nerves are small nerves that carry pain signals from the facet joints to the brain.
During a medial branch block, I use fluoroscopy, which is live X-ray guidance, to place a small amount of medication near the medial branch nerves. If your pain improves after the injection, that response can help confirm that the targeted facet joints are a meaningful source of your pain.
Medial branch blocks are often diagnostic, meaning they help identify the source of pain. If you experience strong but temporary relief, radiofrequency ablation may be discussed as a longer-lasting option.
What Are Facet Joint Injections?
Facet joint injections place medication directly into or near the affected facet joint. These injections may include local anesthetic and, when appropriate, anti-inflammatory medication.
A facet joint injection may help reduce inflammation in the joint and improve movement comfort. It may also provide useful diagnostic information by showing whether the facet joint itself is contributing to your pain.
Facet joint injections and medial branch blocks are closely related, but they are not exactly the same. A facet joint injection targets the joint, while a medial branch block targets the small nerves that carry pain signals from that joint.
Medial Branch Blocks vs. Facet Joint Injections
Both procedures are used to evaluate and treat facet-related spine pain, but they answer slightly different questions.
- A facet joint injection may be used when inflammation inside the joint appears to be part of the problem. Medication is placed into or around the joint to reduce irritation and help clarify whether that joint is involved.
- A medial branch block is used to test whether the medial branch nerves are carrying pain signals from the facet joints. This is especially important when radiofrequency ablation may be considered later.
At VIPS, I choose between these options based on your symptoms, exam findings, imaging, prior treatment response, and goals. The procedure should match the suspected pain source.
Good Candidates for Medial Branch Block Injections or Facet Joint Injections
You may be a good candidate if your symptoms, physical exam, and imaging suggest that your pain may be coming from one or more facet joints in the spine.
Suitable candidates for medial branch blocks or facet joint injections often have pain that worsens with extension, standing, twisting, or certain positions. Some patients have arthritis or degenerative changes on imaging. Others have persistent back or neck pain after an injury, after years of wear and tear, or after previous spine treatment.
The best candidates are also willing to use the procedure as part of a larger plan. A medial branch block or facet joint injection can provide important information, but lasting improvement may also involve rehabilitation, activity changes, medication review, follow-up care, or radiofrequency ablation when appropriate.
What Symptoms Can Facet Joint Injections and Medial Branch Blocks Help Evaluate?
You may benefit from an evaluation for medial branch block injections or facet joint injections if you have:
- Aching low back pain
- Aching neck pain
- Pain that feels more central than radiating
- Pain that worsens with bending backward
- Pain that worsens with twisting
- Pain that becomes worse after standing or walking
- Stiffness in the neck or lower back
- Pain related to spinal arthritis
- Pain from degenerative changes in the spine
- Facet pain after an injury or whiplash
- Persistent spine pain after conservative care
- Pain after spine surgery when facet joints may be involved
These injections are not designed to treat every type of spine pain. For example, pain that travels sharply down the arm or leg from an irritated spinal nerve may be better evaluated with an epidural steroid injection or selective nerve block. That is why I take time to understand the full pattern before recommending a procedure.
Why Choose VIPS for Medial Branch Blocks and Facet Joint Injections?
A Careful Diagnosis Before Treatment
Two patients can have similar back or neck pain for very different reasons. I review your symptoms, physical exam, imaging, medical history, and prior treatments before deciding whether the facet joints are likely contributing to your pain. I am proud to bring the additional expertise of a Certified Life Care Planner to my work. Along with my double-board certifications, this specialized training enables me to assess the long-term medical, rehabilitation, and future care needs of individuals with complex injuries and disabilities.
Image-Guided Precision
Since these injections target such small structures in the spine, accuracy matters substantially. I use fluoroscopy to guide needle placement and help make sure the injection is directed to the intended and most appropriate area.
A Function-Focused Approach
As a physician trained in both PM&R and interventional pain management, I look beyond the pain score. This means that I want to understand whether the pain is limiting your ability to sit, stand, drive, sleep, work, exercise, lift your child, or move through daily life with confidence.
Honest Guidance About Your Next Step
If an injection makes sense, I will explain why in a way that you understand. If another treatment, such as an epidural steroid injection, nerve block, rehabilitation plan, radiofrequency ablation, or surgical opinion is more appropriate, I will tell you directly and explain why.
A Clear Pathway if the Block Works
Medial branch blocks are often diagnostic, which means your response helps guide future care. If you have meaningful but temporary relief, we may discuss radiofrequency ablation, or another related approach, as a longer-lasting option for facet-related spine pain.
A Warm, Unhurried Experience in Burbank
Many patients come to VIPS after feeling rushed, dismissed, or unsure where to turn next. My team and I want you to feel heard, informed, and comfortable asking questions before any procedure is performed.
Double Board-Certified Expertise
I am double board-certified in PM&R and interventional pain management, which allows me to evaluate spine pain from both a functional and procedural perspective. My PM&R training helps me understand how pain affects movement, strength, daily activity, and rehabilitation, while my interventional pain training allows me to perform targeted imaging procedures when they are appropriate.
What Happens During the Procedure?
Before the procedure, I review your symptoms, medical history, imaging, and treatment plan to ensure you understand the reason for the recommended injection.
During the procedure, you are positioned so I can safely access the targeted area of the spine. The skin is cleaned, and a local anesthetic may be used to numb the area. I then use fluoroscopy to guide the needle to the correct location.
Once the needle is positioned, a small amount of medication is injected. The procedure is usually completed fairly quickly, though your full visit may take longer due to preparation, monitoring, and discharge instructions.
Afterward, I will ask you to pay attention to how your pain responds. Your response can help guide the next step in your treatment plan.
What Should You Expect After Medial Branch Block Injections or Facet Joint Injections?
Some patients notice relief soon after the injection, especially if a local anesthetic is used. Relief may be temporary, longer-lasting, or limited, depending on the pain source and the medication used.
You may have mild soreness near the injection site for a short time. I will give you instructions about activity, medications, and what to monitor after the procedure.
For medial branch blocks, the response is especially important. If the injection provides meaningful but temporary relief, it may suggest that the facet joints are contributing to your pain. In that case, radiofrequency ablation may be considered for longer-lasting improvement.
How Long Do Results Last?
The duration of relief depends on the procedure, the medication used, your diagnosis, and how your body responds.
Facet joint injections may provide temporary improvement by calming inflammation in the joint. Medial branch blocks are often used primarily for diagnostic purposes, so relief may be short-lived but still clinically valuable.
If medial branch blocks confirm facet-mediated pain, radiofrequency ablation may be discussed. RFA uses controlled heat energy to quiet selected pain-carrying nerves in properly selected patients for a longer period of time.
Medial Branch Block and Facet Joint Injection FAQs
If neck or back pain is limiting how you move, work, sleep, drive, exercise, or participate in daily life, medial branch block injections or facet joint injections may help clarify whether the facet joints are part of the problem.
At VIPS, Villanueva Institute of Pain and Spine, my team and I are here to listen carefully, review your symptoms and imaging, and help you understand whether an image-guided spine injection is the right next step.
We are located in Burbank and proudly serve patients visiting from Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.
To schedule a consultation for medial branch block injections or facet joint injections in Burbank, CA, call (818) 669-8895 or contact VIPS online today.
Do medial branch blocks treat pain or diagnose it?
Medial branch blocks are most often used for diagnostic purposes. The goal is to see whether temporarily numbing the medial branch nerves significantly improves your neck or back pain. If you notice meaningful relief during the expected window of the local anesthetic, it suggests the facet joints may be a major source of your pain. The relief may be temporary, but the information can be very valuable because it helps determine whether radiofrequency ablation may be an appropriate next step.
What kind of pain do facet joints cause?
Facet joint pain often feels like a deep ache, stiffness, or pressure in the neck, mid-back, or low back. It may feel worse when you stand for long periods, twist, lean backward, get out of a chair, or change positions after sitting. Some patients describe the pain as more localized than radiating, although facet pain can sometimes radiate into nearby areas such as the shoulders, buttocks, hips, or thighs. Because these symptoms can overlap with disc, muscle, joint, and nerve pain, a careful evaluation is important.
Can facet joint pain travel into the leg or arm?
Facet joint pain can sometimes refer discomfort to nearby areas, but it usually does not follow the same sharp, shooting pattern as nerve root pain. For example, lumbar facet pain may be felt in the buttock, hip, or upper thigh, while cervical facet pain may contribute to neck pain, shoulder discomfort, or certain headache patterns. If your pain travels sharply down the arm or leg with numbness, tingling, burning, or weakness, I may evaluate whether a spinal nerve is irritated and whether another treatment, such as an epidural steroid injection or selective nerve block, is more appropriate.
Are these injections image-guided?
Yes. At VIPS, medial branch blocks and facet joint injections are performed with imaging guidance. I use fluoroscopy, which is live X-ray guidance, to help place the needle accurately near the intended joint or nerve target. These are small structures in the spine, so precision matters. Image guidance helps improve accuracy and supports a safer, more controlled procedure.
How soon will I know if a medial branch block worked?
You may notice pain relief the same day, often within the expected time frame of the local anesthetic. I will explain how to track your pain response after the injection, including what activities to test carefully and what changes to pay attention to. The amount of relief, how quickly it begins, and how long it lasts all help us interpret whether the targeted facet joints are likely contributing to your pain. Even temporary relief can be useful because the purpose of the block is often to guide the next step.
What happens if a medial branch block gives temporary relief?
If a medial branch block provides significant but temporary relief, we may discuss radiofrequency ablation. RFA is designed to quiet selected pain-carrying nerves for a longer period of time, which may help properly selected patients experience improved comfort, mobility, and function. Before recommending RFA, I look at your response to the block, your exam, your imaging, your goals, and whether the pattern truly supports facet-mediated pain.
Can these injections help avoid surgery?
In some cases, medial branch blocks or facet joint injections may help manage spine pain without surgery, especially when the pain is coming from the facet joints rather than a condition that requires surgical treatment. However, these procedures are not a replacement for surgery when surgery is truly the better option. If your imaging, neurological exam, or symptoms suggest that a surgical opinion should be considered, I will tell you directly and explain why.
Will I need more than one injection?
Some patients may need only one injection, while others may require a staged diagnostic process. Medial branch blocks are sometimes performed multiple times to confirm that the facet joints are the true pain source before proceeding with radiofrequency ablation. The number of injections depends on your diagnosis, the area being evaluated, your response, insurance requirements, and your overall treatment plan.
How much do medial branch block injections and facet joint injections cost in Burbank, CA?
The cost of medial branch block injections or facet joint injections in Burbank can vary depending on the number of spinal levels treated, whether the cervical, thoracic, or lumbar spine is involved, the procedure setting, and your insurance benefits. During your consultation, my team can help you understand what information may be needed for scheduling, authorization, and cost review. Since coverage can vary, we recommend bringing your insurance information and any referral details, so we can help guide you through the next steps.
What should I bring to my consultation?
Please bring prior medical records, medication lists, procedure notes, surgical history, and imaging studies such as X-rays, MRIs, or CT scans. Actual images are especially helpful because I prefer to review them myself whenever possible, rather than just the written report. The more information I have, the better I can understand what has already been tried, what may have been missed, and whether a medial branch block, facet joint injection, radiofrequency ablation, or another treatment makes the most sense.