Facet Block

Facet Block

What is Facet Block?

The injection of local anesthetic and steroid into a joint in the spine is called a facet block.

Effects of Facet Block

A facet block mainly decreases pain and inflammation in a facet joint or joints.

Candidates for Facet Block

Facet blocks are typically recommended for patients who have pain primarily in their back coming from arthritic changes in the facet joints. Those who have mechanical low back pain are also ideal candidates for facet block.

Your Consultation

Before the procedure, you will be asked to sign a consent form and your blood pressure will be checked. Then the procedure will be done in the fluoroscopy (x-ray) room with you lying on your stomach. For procedures in the neck, an intravenous is needed. Your back is then washed with an antiseptic soap and sterile drapes will be placed. After that, the skin is numbed with a local anesthetic.

The Facet Block Procedure

With the guidance of the x-ray, the needles are placed on the appropriate locations (the joints or the medial branch). Then local anesthetic with or without steroid is injected through the needles and then the needles are removed. After that, your skin will be cleansed and bandages will be applied. The bandages can be taken out the next morning. And before the doctor discharges you, your blood pressure will be checked first.

Recovery

You may feel an immediate improvement with your back pain after the injection from the local anesthetic. It is important to keep track of how you feel for the rest of the day. You may experience some local tenderness for a couple of days after the injection and using an ice pack 3 or 4 times a day will help this. When a steroid is used with the anesthetic, the effect will take place in about 2 or 3 days and will peak in about 2 weeks.

Risks

As with other procedures, there is a slight risk of bleeding, infection, nerve injury, or allergic reaction to the medications used. Some short-term side effects may also occur. You may experience weakness or numbness that can last for several hours if the local anesthetic spreads to nearby nerves. It is also possible that you may have increased pain for a few days after the injection, including localized pain at the injection site. Diabetic people may have short-term elevation of blood sugars. Those who are prone to fluid retention may have increased fluid retention for 1 to 2 weeks.

FAQs

What are the effects of a facet block?

A facet block may be used for therapeutic and/or diagnostic purposes. One of three things may result. 1. The pain does not go away, which means that the pain is probably not coming from the blocked facet joints. This has diagnostic value. 2. The pain goes away and stays away for a few hours but the original pain comes back and does not get better again. This means the block was also of diagnostic value. The pain is possibly coming from the joints, but the steroid was not of benefit. 3. The pain goes away after the block, the pain may come back later that day, but then the pain gets better again over the next few days. This means that the block was of therapeutic value. The steroid had a long-lasting effect on the pain.

Is the procedure painful?

A lot of people say that the stinging/burning of the numbing medicine is the most uncomfortable part of the procedure though each individual may have a different response to the procedure.

What happens during the procedure?

A facet joint block is done by inserting a needle into the center of the facet joint(s). During the procedure, you will be given medication to help you relax, then a local anesthetic in the skin around the area of the back where the needle will be inserted. The doctor watches on a fluoroscope as he inserts the needle to be certain that it goes into the accurate facet joint. Once the doctor is sure the needle is in the facet joint, he will inject a combination of anesthetic into the joint. The whole procedure takes less than 30 minutes.

What is a fluoroscope?

A fluoroscope is a special X-ray TV that allows the doctor to look at your spine and the needle.

Will I have any restrictions after the procedure?

You are not recommended to drive after the procedure. An adult must be present to accompany you home. Also, you should not use heat in the injected areas for the remainder of the day. So there should be no tub bath or soaking in water (i.e. pool, jacuzzi, etc.) for the remainder of the day.

How soon can I return to my normal activities?

After the procedure, you should rest for 24 hours and avoid driving or operating machinery for at least a day.