Facet Joint Blocks

How can this procedure help my pain?

A facet joint block procedure is used quite often to treat chronic pain in the lower back. The facet joints are located at the back of the spine on both sides of the vertebra, where one vertebra overlaps the other. Each vertebra has two sets of facet joints: one pair faces upward and the other downward, providing flexibility and allowing a person to bend at the waist. Each facet joint is supplied by two nerves and surrounded in a protective capsule of lubricating fluid.

Facet joints can become painful due to arthritis of the spine, a back injury or repetitive stress. In addition to being used to relieve chronic pain, the facet joint block procedure is often used to diagnose the source of the chronic pain, as well as to help a patient better tolerate a prescribed physical therapy routine. Most importantly, however, facet joint block procedures have proven to be extremely effective in providing temporary to long term relief of chronic pain and increasing range of motion to a patient’s affected area.

How are these performed?

Facet joint injections are best performed using fluoroscopy to properly target the needle and inject the medicine. The injection will usually contain a small amount of contrast dye so the physician can confirm the medicine is delivered to the precise location needed. Before the needle is inserted, the doctor will clean the area with an antiseptic solution. He or she will let the patient know when the needle is being inserted and when the procedure is over.

The procedure involves injecting a small amount of anesthetic and anti-inflammatory such as a corticosteroid next to the nerve on the outside of the facet joint. Although the actual procedure only takes a few minutes, the patient should plan on spending between 30 and 60 minutes on the table or bed before they can move. After an evaluation to determine if the pain in the problem area has subsided and whether the patient has fully recovered, they will be given permission to go home.

It’s normal for the patient to feel slightly drowsy and experience some numbness afterwards, so it is usually recommended they avoid driving or operating any heavy machinery for at least 12 hours. Ice packs or wet heat are recommended for localized pain at the injection site. The patient can resume normal activities 12 to 24 hours after the procedure is over.