Facet joint pain: diagnosis, conservative care, medial branch blocks, and radiofrequency ablation
A structured overview of facet-mediated spine pain: clinical evaluation and diagnostic uncertainty, conservative care, intra-articular injections, medial branch blocks, and radiofrequency ablation. Educational, not case-specific.
Cervical versus lumbar spine numbering — why the labels on a facet workup can mislead
Cervical facet labels line up with medial-branch numbering, with the C2-3 / third occipital nerve exception for headache of cervical origin. Lumbar labels do not line up cleanly at L5-S1, and a report reading “L5-S1 medial branch block” should not be taken at face value without checking needle positions and fluoroscopic images.
Medial branch blocks — what they are, which levels matter, and when they explain a headache
Explains what medial branch blocks are, why every facet joint requires two nerves to be tested, which cervical and lumbar levels are the usual axial pain generators, and why the C2-3 facet (third occipital nerve) is the anatomic target for post-injury occipital headache.
The facet joints: what they are and why they matter in neck and back injury cases
A brief primer on the facet joints, their mechanical role, their dual medial-branch innervation, and why a normal MRI does not rule out facet-mediated injury.
Radicular pain and referred pain are not the same thing
Radicular pain (nerve-root origin, narrow band), somatic referred pain (deep structural origin, poorly localized), and radiculopathy (objective nerve dysfunction) are three different things.
When a routine MRI is a snapshot: why a static supine study does not always tell the whole story
A standard MRI is a static, unloaded, supine snapshot. Axial-loaded and upright MRI can reveal changes not seen on the same patient’s relaxed supine study.
Why an early MRI and a late MRI can tell different stories
The date of an MRI relative to the incident is often as important as what the report says. Acute fluid-sensitive findings fade; herniations resorb.
