top of page


About 30 percent of all patients experiencing lower back pain are actually suffering from Facet Joint Pain.

Facet Joint Injections/Medial Branch Block Injections

About 30 percent of all patients experiencing lower back pain are actually suffering from Facet Joint Pain. Facet joints control the motion and flexibility of the spine. When these joints become inflamed or irritated, the pain can range from infrequent, sharp pain to chronic, debilitating pain.


If you are suffering from pain in your lower back caused by Facet Joint inflammation or injury, you may have been told surgery is required to relieve your pain. This may not be the case. There’s a minimally-invasive alternative to spinal surgery that can deliver similar or better pain relief without the risks associated with spinal fusion or other aggressive surgical interventions.


Facet Joint Injections relieve the pain and inflammation in your Facet Joints , and, in some cases, may help your physician discover a deeper, underlying cause for your back pain. The injections are a simple, four-step medical procedure that can be completed in a single visit on an outpatient basis.

STEP 1: The skin and tissue above the facet joint is numbed in preparation for the injection of the local anesthetic.

STEP 2: Using a fluoroscope (a specialized X-ray device) Dr. Skaliy guides the needle through the numbed tissue into the facet joint.

STEP 3: Dye is injected to confirm needle placement for optimal results.

STEP 4: Once the needle is properly positioned, Dr. Skaliy injects a mixture of two medications, an anti-inflammatory steroid and a numbing anesthetic.

Depending on the patient’s specific needs, Dr. Skaliy can treat one or more facet joints during the same procedure. The associated neck or back pain may disappear immediately due to the anesthetic. In some cases, the anesthetic wears off before the steroid takes effect. This does not mean the treatment was unsuccessful. The anti-inflammatory attributes of the steroid component may take a few days to be noticed.


Facet joint injections may relieve pain for several days or several months. The benefits differ from patient to patient. Up to three injections may be given per year.

If the treatment is ineffective, it’s possible the pain is caused by another spinal disease or condition. In this case, further tests will be needed to assess the underlying cause of the pain.

Epidural Steroid Injection (ESI): A Proven Effective, Safe Treatment for Back Pain

Facet Block/Medial Branch Injections

Facet Joints are the joints between the vertebrae and the spine that allow the spine to bend, flex and twist. Medial Branch nerves are smaller nerves within these facets. When Fact Joints are inflamed, Medial Branch nerves send pain signals to the brain.


Medial Branch Block Injections are a minimally-invasive, highly-effective, pain-relieving treatment option for patients suffering from Medial Branch nerve or Facet Joint pain. In fact, more than 68 percent of all patients who received Medial Branch injections report significant pain relief, even several months after the procedure.


Medial Branch Block Injections function as both a diagnostic and a treatment for pain. The procedure takes 15 to 30 minutes to complete, and most patients experience immediate results.


What to expect during a Medial Branch Facet Block Injection

The patient lies, comfortably prone, on his or her stomach. Dr. Skaliy administers a local anesthetic to numb the skin around the joint suspected of causing the patient’s pain.


Once the area is numb, a contrast dye is injected. The purpose of the dye is to allow Dr. Skaliy to view the painful area using a specialized camera called a fluoroscope. Using the fluoroscope, Dr. Skaliy can precisely place the injection where it will be of maximum benefit to the patient.


This tool also reduces potential risks associated with this procedure. While the risks are considered very low, patients are encouraged to address any questions about potential risks to Dr. Skaliy during your  .


When Dr. Skaliy has confirmed the injection needle is in the correct location, he attaches a syringe containing the anesthetic medication. The medication is then injected around the Medial Branch nerves in order to “block” the pain signals being sent to the brain.


The initial anesthetic injection will temporarily block sensation in these nerves. If this temporary injection relieves the patient’s pain, Dr. Skaliy will inject a longer-lasting anesthetic into the area around the Medial Branch nerves.


If the initial injection does not relieve the pain, Dr. Skaliy will perform the same temporary procedure on adjacent Facet Joints to identify the source of the patient’s pain. When the joint causing the pain is identified, Dr. Skaliy will inject a more long-term pain-relieving medication into this area.

Radiofrequency Ablation

Dr. Skaliy may recommend Radiofrequency Ablation for more long-term pain relief. This is utilized in conjunction with a Medial Branch Block. Once the Medial Branch Block has established the location of the patient’s pain, this procedure is designed to interrupt the pain signal to the brain while preserving muscle strength and customary sensations.


  • The procedure begins with IV sedation

  • Anesthetic is applied to a small area of the skin

  • Using the fluoroscope, Dr. Skaliy places the Radiofrequency needle along the Medial Branch nerve

  • The targeted nerves are numbed, and Radiofrequency waves are introduced

  • Heat is used to disrupt the nerve’s pain transmission

  • The process may be repeated as necessary

Thanks to the minimally-invasive nature of both Medial Branch Blocks and Radiofrequency Ablation, as well as the immediate relief of symptoms, patients may resume their normal daily activities the very next day.


To learn more about how Facet/Medial Block Injections or Radiofrequency Ablation can benefit you, click here to schedule an appointment with Dr. Skaliy.

bottom of page