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hello this is dr david green ceo of the arizona pain network where we bring you anything and everything educational for pain management today the topic is an overview of medial branch blocks well first lets talk about back and neck pain and how rampant it is it affects ninety percent of americans at some point in life so nine out of ten its the second most common reason that people see a doctor behind the common cold is for back pain back pain is the leading cause of disability and those under the age of 45 up to 40 percent of those who undergo back surgery are unsuccessful so theyre left with failed back surgery syndrome and the cost of back and neck pain in the u.s exceeds 100 billion dollars a year when you look at the spine at every level there are two joints called the facet joints and ill point those out with my cursor here and here these are the bumps on the back called the spinous processes and every side theres a thumbnail side joint size joint called the facet joint the