Diagnostic and therapeutic spinal interventions: Facet joint interventions

Axial spine pain is a common condition that is due to facet joint disease in some patients. Local anesthetic blocks of the medial branches of the dorsal rami of the spinal nerves that innervate facet joints are used to identify painful facet joints. Subsequent radiofrequency neurotomy of the medial branches serving symptomatic facet joints may provide prolonged albeit impermanent pain relief. The diagnostic blocks and radiofrequency treatments are best validated in the cervical spine. Neurologists should be aware that patients with axial spine pain who are referred to a pain clinic or pain management facility are likely to be considered for diagnostic and therapeutic interventions directed at facet joints and their sensory nerve supply.