Shoreline

Hey Derek, the medial nerves basically connect each vertabrea and run verticlly up your spine connecting the nerves from one facet joint to another. A block/numbing of the nerve allows the doc to see if the nerve is the cause of pain. A facet neurotomy is when they cook the medial nerves that connect to the facet nerves to relieve the pain coming from the nerves in a particluar facet joint.

If the medial block didn't help, then likely the pain isn't coming from the nerves in the facet you had injected with Lido and cort. The anti inflamatory action of the cort likely gave relief rather than temporarilly numbing the facet nerves as they inject cortizone. Lidocaine only last a few hours, marcaine lasts 8 to 12 hours but the effects of corizone will last weeks or longer if the pain is from inflamation.

A facet injection is an injection of steroid into an articulating joint along either side of the vertabrea to numb and deliver a steroid to reduce inflamtion. Facet joint pain may be from nerves or other problems like arthritis,spurring, facet syndrome or muscular.

If a facet injection gives relief beyond the life of the lidocaine it may be repeated but they will limit exposure to steroids like they do epidurally. The idea is to facilitate increased movement, range of motion and allow someone to participate in a comprehensive rehab program to stretch and strengthen weakened or injured muscles if there isn't anything to surgicaly correct. A facet injection alone will simply bring temporary relief and shouldn't be used soley for diagnostic purposes because it doesn't give accurate information as to the cause of pain. Where the medial branch block isolates the problem to the nerves coming out of the facet joints.
Good luck, Dave