Overview
Thoracic facet block is a targeted treatment used when the small joints of the thoracic spine contribute to persistent mid back pain. The thoracic facet joints sit on either side of the spine and help guide movement and maintain stability. When these joints become irritated because of wear and tear, posture related strain, muscular imbalance, or injury, they may cause ongoing discomfort.
This pain may remain localised in the mid back or radiate around the ribs. A thoracic facet block involves placing local anaesthetic, sometimes combined with steroid medication, around the medial branch nerves that supply the facet joints. The aim is to reduce inflammation and interrupt pain signals.
If a diagnostic facet block provides clear but temporary relief, radiofrequency ablation may be considered. This procedure targets the same nerves using controlled heat to reduce pain signals and may provide longer lasting relief.
Who this treatment helps
Thoracic facet block or ablation may be considered for people with:
- Localised mid back pain or stiffness
- Pain aggravated by twisting, bending, or prolonged sitting
- Tenderness over the thoracic facet joints
- Pain related to posture strain or previous injury
- Persistent symptoms despite physiotherapy or medication
- Pain patterns suspected to arise from thoracic facet joints
A consultation is required to confirm suitability and ensure the pain pattern matches facet related symptoms.
What is a thoracic facet block
A thoracic facet block is a minimally invasive procedure that targets the medial branch nerves supplying the thoracic facet joints. Local anaesthetic, with or without steroid medication, is injected near these nerves to reduce inflammation and temporarily interrupt pain signals.
This procedure is often used diagnostically to confirm that the facet joints are the main source of pain.
If the block provides meaningful but temporary relief, radiofrequency ablation may be recommended. Radiofrequency ablation uses controlled heat to interrupt pain signals from the same medial branch nerves. Because these nerves only carry pain signals, the treatment does not affect spinal strength or stability.
Fluoroscopy using X ray guidance or ultrasound may be used to improve accuracy and safety.
What to expect during the procedure
- Your consultant reviews the treatment plan and answers any questions
- You lie comfortably on the procedure table, usually face down
- The skin over the mid back is cleaned and numbed with local anaesthetic
- Using imaging guidance, a fine needle is positioned near the medial branch nerves
- For a facet block, local anaesthetic with or without steroid is injected
- For ablation, a specialised needle delivers controlled heat to the nerve
- You are monitored briefly before going home the same day
The procedure usually takes around 15 to 30 minutes.
After the procedure
- Mild soreness or bruising at the injection site is common
- Temporary numbness or warmth in the mid back may occur
- Pain relief from a facet block may be immediate due to local anaesthetic
- Steroid effects may develop gradually over several days
- Ablation may take several weeks to reach full effect
- Most people resume normal activities the following day while avoiding strenuous exercise for 24 hours
Your consultant may recommend physiotherapy or posture focused rehabilitation to support longer term improvement.
Benefits
- May reduce mid back pain and stiffness
- Can help confirm whether facet joints are the source of symptoms
- May improve posture and spinal movement
- Minimally invasive with a short recovery period
- Radiofrequency ablation may provide longer lasting relief in selected cases
- Supports rehabilitation and functional recovery
Possible risks and side effects
Thoracic facet block and ablation procedures are generally safe when performed by experienced clinicians, but all procedures carry some risk.
- Temporary increase in pain
- Mild bruising or soreness
- Light headedness
- Infection, which is rare
- Bleeding, uncommon
- Very rare nerve irritation
Your consultant will explain individual risks and suitability during assessment.
When to consider other options
If symptoms persist or response is limited, your consultant may discuss thoracic epidural injection, thoracic nerve block and PRP, trigger point injection for muscular tension, physiotherapy, posture based rehabilitation, medication review, or combined approaches for complex thoracic pain.
Safety note
Please inform your consultant if you take blood thinning medication, have allergies, diabetes, active infection, are pregnant, or have had previous reactions to steroid or local anaesthetic. Depending on the medications used you may need someone to drive you home after the procedure.
Arrange a consultation to discuss whether thoracic facet block or ablation may be appropriate for your symptoms.
You can also explore our dorsal pain treatments, view all pain treatments, or learn more about our pain management services.