What are the facet joints?
The facet joints sit at the back of the spine and help guide movement. They can become arthritic, but seeing arthritis on a scan does not establish that it is the cause of your pain.
If your MRI report says “facet arthropathy” or “facet arthritis,” the next step is an explanation that connects the finding with your symptoms and examination. Treatment should follow that assessment.
What is a medial branch block?
Small nerve branches called medial branches supply the facet joints. A diagnostic medial branch block places local anesthetic near selected branches to help assess whether the joints are contributing to the pain.
A block is different from radiofrequency ablation or medial branch transection. It is used to gather information before deciding whether a nerve-targeting treatment is reasonable.
What should I pay attention to after a diagnostic block?
Follow the treating team’s instructions about activity and recording your response. It is useful to describe what changed in the activities that usually bring on your pain, how much relief you noticed and how long it lasted.
Ask in advance how the result will be interpreted. The number of blocks, the relief threshold and coverage requirements can differ. A helpful response informs the discussion; it does not guarantee the result of a later procedure.
What treatment choices follow the assessment?
The discussion may include continued nonsurgical treatment, rehabilitation, radiofrequency ablation (RFA), or—in selected patients—endoscopic medial branch transection (MBT). The exact pain source, prior treatment response, risks and your goals all matter.
If a compressed spinal nerve is the main problem, interrupting signals from facet joints would address a different target. Ask what evidence supports the target being proposed for you.
Sources and context
Sources checked November 8, 2026. General education; treatment recommendations require an evaluation. The guideline primarily addresses facet interventions and RFA; it does not validate every mechanical MBT technique.
ASRA Pain Medicine, 2024: diagnostic medial branch blocks Cohen et al., 2020: multispecialty lumbar facet-joint guidelines Arthrex: medial branch transection — manufacturer education