"I Didn't Walk for the Past Eight Months"
One patient's facet injection story — and why finding the real source of your pain matters
For six years, she limped.
It started with an injury. Back pain, then weakness in her right leg. Over time it got worse, until by the time she came to see Dr. Dombrowski, she had barely been able to walk for eight months.
She hadn't sat still. She did physical therapy three times a week for four months. She saw another physician, who gave her a nerve root injection. In her words, it made "no difference at all."
So she kept looking. "I needed something to be able to walk again."
She'd come all the way from the United Kingdom. And she was carrying the kind of stress that anyone with long-term pain will recognize: "I thought I was never going to walk again."
What happened after the procedure
Medication helped a little, but only for a short time. So Dr. Dombrowski performed a medial branch block, a type of facet injection, on her lower back.
Minutes later, the patient walked up and down the hallway about 15 times. Her description:
"The pain is gone. The weakness is gone. The foot is straight again."
"It's better than it's been since probably 2014."
Asked what she would tell someone watching her story, she didn't hesitate:
"There is hope, because I was totally hopeless before this."
Why one injection worked when another didn't
This is the part of her story worth slowing down on.
She had already had an injection, and it did nothing. That doesn't mean injections don't work. It means that injection wasn't aimed at the source of her pain.
Back and leg pain can come from several different places: a pinched nerve root, a disc, the sacroiliac joint, or the small facet joints that link the vertebrae along the back of the spine. Each one calls for a different treatment. Treat the wrong one and nothing changes, no matter how well the procedure is done.
That's why a careful evaluation comes before any needle. And it's why a "failed" injection is sometimes a clue, not a dead end.
What is a medial branch block?
The facet joints are small joints on each side of the spine. Like any joint, they can become inflamed, arthritic, or injured, and they can cause significant back pain.
Each facet joint sends its pain signals through tiny nerves called medial branch nerves. In a medial branch block, Dr. Dombrowski uses X-ray guidance to place a small amount of numbing medicine right next to those nerves.
The block does two jobs:
It relieves pain. When the facet joints are the source, patients often feel the difference quickly, sometimes within minutes.
It confirms the diagnosis. If the pain improves, the facet joints are very likely the cause. That answer opens the door to longer-lasting treatment.
What comes next: longer-lasting relief
The numbing medicine in a medial branch block wears off over time. For many patients, a strong response to the block is the signal that they may be a good candidate for radiofrequency ablation, a procedure that uses heat to quiet those same medial branch nerves so relief can last much longer.
In other words, a successful block is often the first step of a plan, not the last one.
Frequently asked questions
Is a medial branch block surgery? No. It's an outpatient injection done through a thin needle with X-ray guidance. There is no incision.
Does it hurt? Most patients feel pressure and a brief sting from the local anesthetic. You can usually walk out on your own the same day.
How long does the relief last? It varies. The numbing effect is temporary. When a block works well, Dr. Dombrowski will talk with you about radiofrequency ablation for longer-lasting relief.
I already had an injection that didn't help. Is it worth trying again? It may be. Different injections target different structures. If the first one didn't reach the source of your pain, it may not tell you much about what else could work. An evaluation is the only way to know.
Am I a candidate? Facet joint pain is common in people with long-lasting low back pain, especially after an injury, and in people whose pain hasn't improved with physical therapy or medication. The only way to know is an evaluation.
Don't give up on walking without pain
This patient had tried therapy, medication, and another physician's injection. She'd traveled across an ocean. She'd nearly lost hope. What she needed was the right diagnosis.
Call The Washington Pain Center at (202) 883-8001, or book an appointment online. Same-day appointments are available, with procedures performed during the visit when your insurance allows.
📍 3301 New Mexico Avenue NW, Suite 346, Washington, DC 20016
Learn more about our injections and nerve blocks.
This patient shared her story with permission. Individual results vary. This article is for educational purposes and is not a substitute for a medical evaluation.