What
is a facet joint block?
A
facet joint block involves the injection of a substance into
or next to the facet joint. Typically, in a diagnostic block,
local anesthetic is used. In most cases a corticosteroid is
also injected. Radiographic control is mandatory in accurately
and safely placing the needle. The purpose of facet joint blocks
is twofold. Initially, it is a diagnostic block. If the patient
receives 50% or greater pain relief for at least 2 hours, there
is an increased likelihood that the facet joint is important
in the patients pain syndrome. The block is then repeated to
confirm the diagnosis. The second purpose of the facet block
is to reduce pain. Corticosteroids can help reduce the pain
secondary to inflammatory substances that sensitize nerve endings.
Are
facet joint blocks safe?
Yes.
The risks of facet joint blocks are very low with the use of
x-ray control. Patients may experience some small amount of
injection site tenderness. This will use the result in several
days. Risks such as headache, infection, or bleeding are extremely
rare.
Do
the injections hurt?
Patients
undergoing facet joint injections all receive local anesthetic
to anesthetize the skin and deeper tissues. The patients may
elect to receive intravenous sedation consisting of a sedative
and/or a narcotic medication.
How
long does it take for the injections to work?
Typically,
the local anesthetic will work within 10 minutes and last up
to two hours. The corticosteroid usually takes longer for pain
reduction. It usually takes anywhere from 1 - 5 days for pain
relief to occur if the pain is coming from the joint.
When
can I resume normal activities following the block?
Most
patients can resume normal activity the next day. In some cases,
patients may require an additional day.
What
if I don't get any relief from the facet joint injections?
If
you don't get relief from the facet joint injections, it is
unlikely that this is a source of your pain. You should then
consider with your physician the other possible sources of your
pain. This may include other diagnostic blocks or imaging studies.
This procedure takes 15-30 minutes per level. You will be asked
to lie in a prone position (face down) on a table in the fluoroscopy
suite. Your back will be cleansed with an antiseptic (usually
iodine) solution and the area will be numbed. The radiologist
will use fluoroscopy (x-ray) to guide the placement of a thin
needle to the area of a group of nerves that cause pain of facet
syndrome. After correct needle placement is confirmed by x-rays,
a small amount of local anesthetic and steroid will be injected.
Due to the effects of certain medications, your driving reflexes
may be impaired. You will need someone to drive you home after
the procedure. Please make the necessary arrangements. PLEASE
NOTIFY A TECHNOLOGIST IF THERE IS A CHANCE THAT YOU MAY BE PREGNANT!
