Cervical Medial Branch Block (Cervical Facet Joint Nerve Block)
If you are living with chronic neck pain or persistent shoulder aching that has not improved with conventional treatment, a Cervical Medial Branch Block may be the procedure that helps identify the source of your pain — and opens the door to effective, longer-lasting relief.
Understanding the Two Types of Neck Pain
Accurate pain classification is the essential first step before any treatment decision is made. Neck pain falls into two clinically distinct categories, each with a different underlying mechanism and a different treatment approach:
Localised neck pain — pain confined to the neck itself, with possible referral into the shoulder and shoulder blade. This pattern typically originates from dysfunction or degeneration of the cervical facet joints — the small paired joints that connect the vertebrae of the neck. It does not travel down the arm.
Radicular neck pain — pain, tingling, or numbness that radiates from the neck down the arm into the hand or fingers. This pattern suggests irritation or compression of a cervical nerve root rather than isolated facet joint pathology, and is generally better managed with a Cervical Epidural Steroid Injection (Cervical ESI) rather than a medial branch block.
Who Is This Procedure Suitable For?
Patients with cervical facet joint syndrome — confirmed or suspected degeneration or inflammation of the small joints of the cervical spine
Patients with chronic localised neck and shoulder pain — persistent pain in the neck and shoulder area without any radiation down the arm or into the fingers
Patients diagnosed with Office Syndrome — chronic neck and shoulder pain arising from prolonged desk work and poor posture, who have undergone physiotherapy but continue to experience recurring pain that does not fully resolve
The Procedure (Approximately 15–20 Minutes)
This is a safe, minimally invasive procedure. General anaesthesia is not required and the total procedure time is only 10–15 minutes.
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The patient lies on their side in a comfortable, relaxed position
The physician uses real-time ultrasound guidance or fluoroscopy (live X-ray) to precisely locate the target medial branch nerve at the relevant cervical level
A small volume of local anaesthetic is injected onto the target nerve. Patients may feel mild pressure at the injection site, but the procedure is generally well tolerated with minimal discomfort
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Expected Outcomes
The primary purpose of the Cervical Medial Branch Block is diagnostic — it confirms whether the cervical facet joints are the true source of the patient's pain, which then directly guides the treatment plan:
If pain is immediately and significantly reduced following the injection: This confirms that the cervical facet joints are the pain source. The physician will typically recommend proceeding to Cervical Medial Branch Radiofrequency Ablation (Cervical RFA) — a procedure that uses radiofrequency energy to deactivate the same nerve branches and deliver pain relief lasting months rather than hours.
If pain relief is partial or the block is used therapeutically: The physician may recommend repeating the block as part of an ongoing treatment plan, or explore alternative approaches based on the patient's response.
The information obtained from this single procedure allows the physician to make a confident, evidence-based decision about the most appropriate long-term treatment pathway for each individual patient.
Post-Procedure Care
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Driving: Do not drive on the day of the procedure. Mild dizziness is possible following the injection — arrange for someone to take you home.
Rest: Avoid strenuous physical activity and heavy exertion for the remainder of the day.
Injection site: Mild redness or soreness at the injection point is normal and typically resolves on its own within 1–2 days.
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Long-Term Prevention of Neck Pain
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Posture correction — adjust your sitting position at work, and be mindful of your neck posture when using a mobile phone; avoid prolonged forward head posture or looking down at a screen.
Targeted exercise — regularly strengthen the neck, shoulder, and deep cervical stabiliser muscles; a physiotherapist can guide you on which exercises are most appropriate for your specific pattern of pain.
Movement breaks — when working in a fixed position for extended periods, stand up and change position or stretch every 1–2 hours to reduce cumulative muscle tension and joint stress.
Ergonomic equipment — choose a pillow that supports the natural curve of the neck and a chair that supports the natural lumbar curve; good ergonomic support over time meaningfully reduces stress on the cervical facet joints.
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Pain Management at Bangkok Interventional Clinic
At Bangkok Interventional Clinic, we focus on personalised, in-depth pain management tailored to each individual.
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- All patients are evaluated and treated by a board-certified pain specialist, ensuring accuracy, safety, and effective care.
- Targeted interventional procedures for fast and effective symptom relief
- Patient education to support sustainable, long-term self-care
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Our goal is to meaningfully improve the quality of life of every patient we treat. If you are living with pain that affects your daily life, the right diagnosis and the right treatment plan are where change begins.
